昆仙胶囊治疗狼疮肾炎伴肾病综合征表现患者的肾功能及血清IgE IgG水平改善研究
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摘要
目的研究昆仙胶囊对狼疮肾炎伴肾病综合征表现患者的肾功能及血清免疫球蛋白E(IgE)、免疫球蛋白G(IgG)水平的影响。方法回顾性分析2016年10月至2018年6月在我院就诊的狼疮肾炎伴肾病综合征表现患者108例,根据治疗方式不同,分为研究组(56例)和对照组(52例),对照组采用糖皮质激素和环磷酰胺治疗,研究组在此基础上联合昆仙胶囊治疗。比较2组患者临床疗效、肾功能改善情况及血清IgE、IgG水平。结果研究组和对照组临床有效率分别为87.5%和67.3%,2组比较差异有统计学意义(P<0.05)。研究组系统性红斑狼疮活动指数(SLEDAI)评分明显低于对照组,差异有统计学意义(P<0.05)。研究组尿蛋白定量、尿素氮(BUN)、血肌酐(Scr)水平均明显低于对照组,差异有统计学意义(P<0.05)。治疗后,2组血清IgE、IgG水平均明显降低(P<0.05),且研究组血清IgE、IgG水平明显低于对照组,差异有统计学意义(P<0.05)。结论昆仙胶囊治疗狼疮肾炎伴肾病综合征表现患者疗效确切,可明显改善患者肾功能状况,降低血清免疫球蛋白水平,值得临床推广。
Objective To investigate the effect of Kunxian capsule on therenal function and serum immune globulin E(IgE) and immune globulin G(IgG) levels in patients with lupus nephritis and nephrotic syndrome. Methods The clinical data of 108 patients with lupus nephritis and nephrotic syndrome admitted to our hospital between October 2016 and June 2018 were retrospectively analyzed. According to different treatment methods, all patients were divided into the study group(n=56) and the control group(n=52). The control group was treated with glucocorticoid and cyclophosphamide. In addition, the study group was treated with Kunxian capsule. The clinical efficacy, im-provement of renal function and serum IgE and IgG levels in the two groups were compared. Results The clinical effective rate in the study group and the control group was 87.5% and 67.3%, respectively, withstatistically significant difference between the two groups(P<0.05). The systemic lupus erythematosus activity index(SLEDAI) score in the study group was significantly lower than that in the control group, with statistically significant difference( P<0.05). The levels of urine protein quantification, blood urea nitrogen(BUN) and serum creatinine(Scr) in the study group were significantly lower than those in the control group, with statistically significant differences(all P<0.05). After the treatment, the serum IgE and IgG levels in the two groups were significantly lower than those at the baseline(both P<0.05), and the serum IgE and IgG levels in the study group were significantly lower than those in the control group,with statistically significant differences(both P<0.05). Conclusion Kunxian capsule is effective in the treatment of lupus nephritis combined with nephrotic syndrome. It may significantly improve the renal function of patients and re-duce the level of serum immunoglobulin, which justifies its widespread use in clinical settings.
Objective To investigate the effect of Kunxian capsule on therenal function and serum immune globulin E(IgE) and immune globulin G(IgG) levels in patients with lupus nephritis and nephrotic syndrome. Methods The clinical data of 108 patients with lupus nephritis and nephrotic syndrome admitted to our hospital between October 2016 and June 2018 were retrospectively analyzed. According to different treatment methods, all patients were divided into the study group(n=56) and the control group(n=52). The control group was treated with glucocorticoid and cyclophosphamide. In addition, the study group was treated with Kunxian capsule. The clinical efficacy, im-provement of renal function and serum IgE and IgG levels in the two groups were compared. Results The clinical effective rate in the study group and the control group was 87.5% and 67.3%, respectively, withstatistically significant difference between the two groups(P<0.05). The systemic lupus erythematosus activity index(SLEDAI) score in the study group was significantly lower than that in the control group, with statistically significant difference( P<0.05). The levels of urine protein quantification, blood urea nitrogen(BUN) and serum creatinine(Scr) in the study group were significantly lower than those in the control group, with statistically significant differences(all P<0.05). After the treatment, the serum IgE and IgG levels in the two groups were significantly lower than those at the baseline(both P<0.05), and the serum IgE and IgG levels in the study group were significantly lower than those in the control group,with statistically significant differences(both P<0.05). Conclusion Kunxian capsule is effective in the treatment of lupus nephritis combined with nephrotic syndrome. It may significantly improve the renal function of patients and re-duce the level of serum immunoglobulin, which justifies its widespread use in clinical settings.
引文
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[12]Ward MM.Recent clinical trials in lupus nephritis[J].Rheum Dis Clin North Am,2014,40(3):519-535.
[13]陈菊,周君.糖皮质激素辅助硼替佐米治疗难治性狼疮性肾炎临床研究[J].临床军医杂志,2017,45(8):863-864,867.
[14]秦登优,伍正彬,田恩,等.他克莫司联合环磷酰胺和糖皮质激素治疗狼疮性肾炎的疗效观察[J].医学研究杂志,2018,47(7):141-144.
[15]张宁,易无庸.昆仙胶囊临床应用进展[J].中医临床研究,2014,6(7):147-148.
[16]曾又佳,孔慧霞,李顺民.昆仙胶囊治疗慢性肾脏病蛋白尿的临床疗效及其安全性观察[J].新中医,2014,46(7):74-76.
[17]Anders HJ,Rovin B.A pathophysiology-based approach to the diagnosis and treatment of lupus nephritis[J].Kidney Int,2016,90(3):493-501.
[2]马一,建宏.狼疮性肾炎的治疗进展[J].医学综述,2018,24(7):1334-1338,1343.
[3]Cadet MJ.Identification and management of lupus nephritis:an overview[J].J Nurse Pract,2018,14(1):1-6.
[4]Song DI,Guo WY,Wang FM,et al.Complement alternative pathway′s activation in patients with lupus nephritis[J].Am J Med Sci,2017,535(3):247-257.
[5]秦军建,邢艳芳,黄爱英.他克莫司联合甲泼尼龙治疗狼疮性肾炎肾病综合征的临床疗效[J].实用医学杂志,2018,34(16):2758-2760,2765.
[6]Kamen DL,Zollars ES.Corticosteroids in lupus nephritis and central nervous system lupus[J].Rheum Dis Clin North Am,2016,42(1):63-73.
[7]Chang CM,Wu PH,Chiang JH,et al.Integrative therapy decreases the risk of lupus nephritis in patients with systemic lupus erythematosus:a population-based retrospective cohort study[J].JEthnopharmacol,2017,196(20):201-212.
[8]Dos Santos M,Poletti PT,Milhoransa P,et al.Unraveling the podocyte injury in lupus nephritis:clinical and experimental approaches[J].Semin Arthritis Rheum,2017,46(5):632-641.
[9]Parikh SV,Alvarado A,Malvar A,et al.The kidney biopsy in lupus nephritis:past,present,and future[J].Semin Nephrol,2015,35(5):465-477.
[10]于峰,赵明辉.狼疮性肾炎的治疗策略:依据病理指导临床[J].中国实用内科杂志,2015,35(6):467-470.
[11]周金成,王吟,周丽美.自拟狼疮方辅助强化免疫调节方案治疗狼疮性肾炎疗效及对肾功能、凝血功能指标的影响[J].中国中医急症,2018,27(6):1079-1081.
[12]Ward MM.Recent clinical trials in lupus nephritis[J].Rheum Dis Clin North Am,2014,40(3):519-535.
[13]陈菊,周君.糖皮质激素辅助硼替佐米治疗难治性狼疮性肾炎临床研究[J].临床军医杂志,2017,45(8):863-864,867.
[14]秦登优,伍正彬,田恩,等.他克莫司联合环磷酰胺和糖皮质激素治疗狼疮性肾炎的疗效观察[J].医学研究杂志,2018,47(7):141-144.
[15]张宁,易无庸.昆仙胶囊临床应用进展[J].中医临床研究,2014,6(7):147-148.
[16]曾又佳,孔慧霞,李顺民.昆仙胶囊治疗慢性肾脏病蛋白尿的临床疗效及其安全性观察[J].新中医,2014,46(7):74-76.
[17]Anders HJ,Rovin B.A pathophysiology-based approach to the diagnosis and treatment of lupus nephritis[J].Kidney Int,2016,90(3):493-501.