参芪地黄汤联合环磷酰胺冲击疗法治疗狼疮性肾炎的疗效及影响因素分析  

Analysis of therapeutic effect and influencing factors of Shenqi Dihuang decoction in the treatment of lupus nephritis

作　　者：贾江伟 刘晓红 JIA Jiangwei;LIU Xiaohong(Department of Nephrology,Shangcai County People's Hospital,Zhumadian 450006,China;Department of Infectious Diseases,Shangcai County People's Hospital,Zhumadian 450006,China)

机构地区：[1]河南省驻马店市上蔡县人民医院肾内科,河南驻马店450006 [2]河南省驻马店市上蔡县人民医院感染疾病科,河南驻马店450006

出　　处：《中国民族医药杂志》2025年第2期21-24,共4页Journal of Medicine and Pharmacy of Chinese Minorities

摘　　要：目的:探讨参芪地黄汤治疗狼疮性肾炎(LN)的疗效,并分析疗效的影响因素。方法:选取2020年1月—2021年12月在我院诊治的LN患者72例,随机数字表法分为2组,对照组36例和研究组36例,对照组给予常规西药治疗,研究组在对照组的基础上给予参芪地黄汤治疗,比较两组治疗前后的中医症候积分、系统性红斑狼疮活动指数(SLEDAI)、肾功能指标,临床治疗疗效和不良反应发生情况,并分析临床有效的影响因素。结果:治疗后,两组中医症候积分、SLEDAI较治疗前均降低(P<0.05),且研究组低于对照组(P<0.05)。治疗后,两组血肌酐(Scr)较治疗前均降低(P<0.05),白蛋白(ALB)较治疗前升高(P<0.05),且研究组Scr低于对照组(P<0.05),ALB高于对照组(P<0.05)。研究组临床疗效优于对照组,研究组的临床治疗总有效率高于对照组的(P<0.05)。研究组不良反应发生率低于对照组的(P<0.05)。经单因素分析,肾损害病程、Scr、尿量、尿蛋白定量是临床有效的影响因素(P<0.05);经二元Logistic回归分析,肾损害病程长是临床有效的危险因素(P<0.05),尿量多是临床有效的保护因素(P<0.05)。结论:参芪地黄汤治疗LN,可有效改善中医症候、肾功能,降低SLEDAI、不良反应,提高临床治疗疗效;临床有效和肾损害病程、尿量有关。Objective:To explore the curative effect of Shenqi Dihuang decoction on lupus nephritis(LN)and analyze the influencing factors of the curative effect.Methods:72 cases of LN patients in our hospital from January,2020 to December,2021 were randomly divided into two groups,the control group(36 cases)and the research group(36 cases).The control group was treated with conventional western medicine,while the research group was treated with Shenqi Dihuang decoction on the basis of the control group.The TCM symptom score,systemic lupus erythematosus activity index(SLEDAI),renal function index,clinical curative effect and adverse reactions were compared between the two groups before and after treatment.Results:After treatment,the scores of TCM symptoms and SLEDAI in the two groups were lower than those before treatment(P<0.05),and the study group was significantly lower than the control group(P<0.05).After treatment,the serum creatinine(Scr)in both groups decreased(P<0.05),and the albumin(ALB)in both groups increased(P<0.05),and the Scr in the study group was significantly lower than that in the control group(P<0.05),and the ALB in the study group was significantly higher than that in the control group(P<0.05).The clinical curative effect of the study group was better than that of the control group,and the total effective rate of the study group was 94.44%,which was significantly higher than that of the control group(P<0.05).The incidence of adverse reactions in the study group was 5.56%,which was significantly lower than that in the control group(25.00%,P<0.05).By univariate analysis,the course of renal damage,Scr,urine volume and urine protein quantification are the effective clinical influencing factors(P<0.05).Logistic regression analysis showed that the long course of renal damage was a clinically effective risk factor(P<0.05),and urine output was a clinically effective protective factor(P<0.05).Conclusion:Shenqi Dihuang decoction can effectively improve TCM symptoms and renal function,reduce SLEDAI and adverse react

关 键 词：参芪地黄汤 狼疮性肾炎 临床效果 中医证候 肾功能 不良反应 

分 类 号：R593.242[医药卫生—内科学]