参芪地黄汤加减联合雷公藤多苷片治疗慢性肾小球肾炎的效果及安全性分析  

Analysis of the efficacy and safety of the combined treatment of adjusted Codonopsis and Astragalus decoction and Tripterygium Glycosides tablets in the treatment of chronic glomerulonephritis

作　　者：王惠 张芳 乔景轩 Wang Hui;Zhang Fang;Qiao Jing-xuan(Department of Pharmacy,Kaifeng Hospital of Traditional Chinese Medicine,Kaifeng 475000,Henan,China)

机构地区：[1]开封市中医院药学部,河南开封475000

出　　处：《四川生理科学杂志》2025年第4期723-726,共4页

基　　金：河南省医学科技攻关计划联合共建项目(编号:LHGJ20221058)。

摘　　要：目的:探讨参芪地黄汤加减联合雷公藤多苷片治疗慢性肾小球肾炎(Chronic glomerulonephritis,CGN)的疗效,并分析其对中医证候积分、肾功能的影响。方法:选取2023年1月至2024年2月于本院诊治的106例CGN患者开展回顾性分析,依据治疗方案分为单一组(n=53)、联合组(n=53)。单一组采取雷公藤多苷片治疗,联合组采取参芪地黄汤加减联合雷公藤多苷片治疗。比较两组治疗前后中医证候积分、肾功能[血尿素氮(Blood urea nitrogen,BUN)、血肌酐(Serum creatinine,Scr)、尿微量白蛋白(Microalbumin,MALB)、24 h尿蛋白定量(24-hour urine protein,24 h-Upro)]、炎症-氧化应激指标[白细胞介素-6(Interleukin-6,IL-6)、白细胞介素-18(Interleukin-8,IL-18)、活性氧(Reactive oxygen species,ROS)、丙二醛(Malondialdehyde,MDA)、谷胱甘肽过氧化物酶(Glutathione peroxidase,GSH-PX)]、T淋巴细胞亚群(CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+))及不良反应。结果:联合组总有效率高于单一组(P<0.05);治疗后,联合组中医证候积分、BUN、Scr、MALB、24 h-Upro水平低于单一组(P<0.05);联合组治疗后血清IL-6、IL-18、ROS、MDA水平低于单一组,GSH-PX水平高于单一组(P<0.05);联合组治疗后外周血CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)高于单一组(P<0.05);两组不良反应对比无明显差异。结论:CGN患者应用参芪地黄汤加减联合雷公藤多苷片治疗的疗效确切,可改善临床症状、肾功能,抑制炎症-氧化应激反应,改善机体免疫功能,且具有一定安全性。Objective:To investigate the efficacy of adjusted Codonopsis and Astragalus decoction combined with Tripterygium Glycosides tablets in the treatment of Chronic glomerulonephritis(CGN),and analyze its impact on TCM syndrome score and renal function.Methods:A total of 106 patients with CGN treated in our hospital from January 2023 to February 2024 were selected and retrospectively analyzed.They were divided into single group(n=53)and combined group(n=53)according to the treatment schemes.The single group was treated with Tripterygium Glycosides tablets,and the combined group was treated with adjusted Codonopsis and Astragalus decoction combined with Tripterygium Glycosides tablets.The TCM syndrome score,renal function[Blood urea nitrogen(BUN),Serum creatinine(Scr),microalbuminuria(MALB),24-hour urinary protein quantitation(24h-Upro)],inflammation-oxidative stress indicators[Interleukin-6(IL-6),Interleukin-18(IL-18),Reactive oxygen species(ROS),Malondialdehyde(MDA),Glutathione peroxidase(GSH-PX)],T lymphocyte subsets(CD3^(+),CD4^(+)and CD4^(+)/CD8^(+))before and after treatment were compared.The adverse reactions of the two groups were also compared.Results:The total effective rate of the combined group was higher than that of the single group(P<0.05).After treatment,the TCM syndrome score and levels of BUN,Scr,MALB,and 24 h-Upro in the combined group were lower than those in the single group(P<0.05).After treatment,the levels of serum IL-6,IL-18,ROS,and MDA in the combined group were lower than those in the single group,while the level of GSH-PX in the combined group was higher than that in the single group(P<0.05).The CD3^(+),CD4^(+),and CD4^(+)/CD8^(+)in peripheral blood of the combined group were higher than those of the single group after treatment(P<0.05).There was no significant difference in adverse reactions between the two groups.Conclusion:The treatment of CGN patients with adjusted Codonopsis and Astragalus decoction combined with tripterygium glycosides tablets has a definite therapeutic effect,which ca

关 键 词：慢性肾小球肾炎 参芪地黄汤加减 雷公藤多苷片 疗效 氧化应激 免疫功能 

分 类 号：R277.5[医药卫生—中医学] R692.3