益肾祛瘀化湿汤联合吗替麦考酚酯、泼尼松治疗狼疮性肾炎患者的疗效分析  

Therapeutic effect of Yishen Quyu Huashi decoction combined with mycophenolate mofetil and prednisone in the treatment of lupus nephritis

作　　者：尤仙 张艳[2] 王璐瑶[2] 谭世超 You Xian;Zhang Yan;Wang Lu-yao;Tan Shi-chao(Department of Nephrology,Xiping People's Hospital,Zhumadian 463900,Henan,China;Department of Nephrology,The First Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,China)

机构地区：[1]西平县人民医院肾内科,河南驻马店463900 [2]郑州大学第一附属医院肾内科,河南郑州450000

出　　处：《四川生理科学杂志》2024年第1期74-77,共4页Sichuan Journal of Physiological Sciences

摘　　要：目的:探究益肾祛瘀化湿汤联合吗替麦考酚酯、泼尼松治疗狼疮性肾炎(Lupus nephritis,LN)患者的效果。方法:选取2020年2月至2022年8月我院收治的84例LN患者作为研究对象,根据药物治疗方案不同,分为西药组和中西药联合组,各42例。西药组采用吗替麦考酚酯和泼尼松治疗,中西药联合组在西药组基础上增加口服益肾祛瘀化湿汤治疗。治疗6 m后,对比两组总有效率、系统性红斑狼疮疾病活动指数(Systemic lupus erythematosus disease activity index,SLEDAI)评分、肾功能指标、炎性因子、外周血树突状细胞(Dendritic cells,DCs)功能和不良反应。结果:治疗6 m后,中西药联合组总有效率明显高于西药组(P<0.05);中西药联合组SLEDAI评分、24 h尿蛋白定量(24 hour urine protein quantification,24 h UP)、血肌酐,血清白细胞介素(Interleukin,IL)-23、IL-17水平明显低于西药组(P<0.05),白蛋白、分化抗原(Cluster of differentiation,CD)80、CD86、CD1a水平明显高于西药组(P<0.05);两组不良反应总发生率无明显差异(P>0.05)。结论:益肾祛瘀化湿汤联合吗替麦考酚酯、泼尼松治疗LN患者的效果显著,可有效提高肾功能及DCs功能,改善临床症状,调节IL-23/IL-17炎症轴,且具有较高的用药安全性。Objective:To explore the effect of Yishen Quyu Huashi decoction combined with mycophenolate mofetil and prednisone in the treatment of lupus nephritis(LN).Methods:Eighty-four patients with LN admitted to our hospital from Feb.2020 to Aug.2022 were collected as research objects.According to different drug treatment plans,all patients were divided into western medicine group and combined Chinese and western medicine group,42 cases in each group.The western medicine group was treated with mycophenolate mofetil and prednisone,and combined Chinese and western medicine group was treated with oral Yishen Quyu Huashi decoction on the basis of the western medicine group.After 6 months of treatment,the total effective rate,systemic lupus erythematosus disease activity index(SLEDAI)score,renal function indexes,inflammatory factors,peripheral blood dendritic cell(DCs)function and adverse reactions were compared between the two groups.Results:After 6 months of treatment,the total effective rate of the combined Chinese and western medicine group(92.86%)was obviously higher than that of the western medicine group(76.19%)(P<0.05);SLEDAI score,24 hour urine protein quantification(24 h UP),levels of creatinine,interleukin(IL)-23 and IL-17 in the combined Chinese and western medicine group were obviously lower than those in the western medicine group(P<0.05),and the levels of albumin,cluster of differentiation(CD)80,CD86 and CD1a were obviously higher than those in the western medicine group(P<0.05);there was no significant difference in the total incidence of adverse reactions between the two groups(P>0.05).Conclusion:Yishen Quyu Huashi decoction combined with mycophenolate mofetil and prednisone can effectively improve renal function and DCs function,improve clinical symptoms,regulate IL-23/IL-17 inflammatory axis,and has high drug safety.

关 键 词：狼疮性肾炎 益肾祛瘀化湿汤 树突状细胞功能 

分 类 号：R692.3[医药卫生—泌尿科学]