雷公藤多苷、来氟米特及小剂量激素治疗特发性膜性肾病的临床分析  

Clinical Analysis of Tripterygium Glycosides,Leflunomide and Small-dose Hormone in the Treatment of Idiopathic Membranous Nephropathy

作　　者：高宇 吴付弦 刘杨梅 GAO Yu;WU Fuxian;LIU Yangmei(Department of Nephrology,Pizhou Hospital of Traditional Chinese Medicine,Pizhou,Jiangsu Province,221300 China)

机构地区：[1]邳州市中医院肾病科,江苏邳州221300

出　　处：《中外医疗》2023年第26期90-93,共4页China & Foreign Medical Treatment

摘　　要：目的探讨雷公藤多苷+来氟米特及小剂量激素治疗特发性膜性肾病的临床疗效。方法随机选取2020年4月—2023年2月邳州市中医院收治的50例特发性膜性肾病患者,按照随机数表法分成两组,每组25例。对照组采取雷公藤多苷联合小剂量激素治疗,观察组采取雷公藤多苷+来氟米特及小剂量激素治疗。对比两组患者治疗总有效率、生化指标和不良反应发生情况。结果观察组治疗总有效率(96.00%)高于对照组的72.00%,差异有统计学意义(χ^(2)=5.357,P<0.05);治疗前,观察组患者各项生化指标数据比较,差异无统计学意义(P>0.05),治疗后,两组患者各项生化指标数据均改善,观察组生化指标包括总胆固醇、三酰甘油、肾损伤分子、24 h尿蛋白和血清白蛋白水平均显著低于对照组,差异有统计学意义(P<0.05);治疗后,两组患者不良反应发生率比较,差异无统计学意义(P>0.05)。结论在来氟米特联合小剂量激素治疗中加入雷公藤多苷可显著提高特发性膜性肾病的治疗效果,对于改善患者生化指标有显著意义,治疗手段值得推广。Objective To explore the clinical efficacy of tripterygium glycosides combined with leflunomide and smalldose hormone in idiopathic membranous nephropathy.Methods 50 patients with idiopathic membranous nephropathy admitted to Pizhou Hospital of Traditional Chinese Medicine from April 2020 to February 2023 were selected and divided into 2 groups according to random number table method,with 25 cases in each group.The control group was treated with tripterygium glycosides combined with small-dose hormone therapy,and the observation group was treated with tripterygium glycosides+leflunomide and small-dose hormone therapy program.The total effective rate,biochemical indexes and the occurrence of adverse reactions were compared between the two groups.Results The total effective rate of the observation group was 96.00%,which was higher than the 72.00%of the control group,the difference was statistically significant(χ^(2)=5.357,P<0.05).Before treatment,there was no statistically significant difference in the biochemical index data of patients in the observation group(P>0.05).After treatment,the biochemical index data of the two groups were improved,and the biochemical indexes of the observation group,including total cholesterol,triacylglycerol,renal injury molecules,24-hours urinary protein and serum albumin were significantly lower than those of the control group,and the differences were statistically significant(P<0.05).After treatment,there was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion The addition of tripterygium glycosides to leflunomide combined with low-dose hormone therapy can significantly improve the therapeutic effect of idiopathic membranous nephropathy,and it has significant significance for the improvement of biochemical indexes of the patients,and the therapeutic means is worthy of popularization.

关 键 词：特发性膜性肾病 雷公藤多苷 来氟米特 醋酸泼尼松片 

分 类 号：R692[医药卫生—泌尿科学]