中西医结合治疗轻度活动期狼疮性肾炎的疗效观察
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摘要
【目的】:观察中西医结合治疗轻度活动期狼疮性肾炎(LN)的临床疗效及对复发率、不良反应发生率的影响。
【方法】:将40例轻度活动期的狼疮性肾炎患者按1∶1比例随机分为治疗组和对照组。治疗组在激素治疗的基础上,配合中药辨证加减治疗,对照组单使用激素治疗,观察各组病例中患者纳入时及治疗1年期间临床症状、体征、血常规、补体C3、C4、24h尿蛋白定量、肝肾功能等指标,以观察患者的临床疗效及复发、不良反应发生情况。
【结果】:(1)治疗组总有效率(95.0%)与对照组总有效率(70.0%)相比有显著差异(P＜0.05):(2)治疗组与对照组复发率相比较,差别有统计学意义(P＜0.05);(3)治疗组与对照组不良反应发生率相比较,差别有统计学意义(P＜0.05);(4)治疗组治疗后24h尿蛋白定量下降显著低于对照组(P＜0.01);(5)治疗组治疗后补体C3、C4值显著高于对照组(P＜0.01):(6)治疗组可有效减少激素使用量,与对照组比较有非常显著差别(P＜0.01)。
【结论】:在提高轻度活动期狼疮肾患者的临床疗效、控制LN复发、降低不良反应的发生率、减少激素使用量、降低尿蛋白等方面,中西医结合治疗组疗效优于激素组。
[Purpose] : To observe the clinical effect of the treatment combining traditional Chinese and western medicine on lupus nephritis (LN) in Mildly active and analyze the rate of relapsing , the incidence of adverse reactions.
[Method] : 40 cases of patients with lupus nephritis in Mildly active, randomly divided into treatment and control groups by 1:1 ratio. Treat the conventional treatment group with Chinese medicine Syndrome addition and subtraction on the basis of hormone therapy, and with conventional western medicine treatment for the control group. Observe the treatment of symptoms and signs, blood, complement C3, C4, 24h urine protein, liver and kidney function indicators of patients and analyze the patients' clinical efficacy and recurrence, the occurrence of adverse reactions in each group during one year.
[Results] : (1) There is significant difference between the total efficiency of treatment group (95.0%) and the control group (70.0%) (P <0. 05) ; (2) it has statistical significance of the difference between the relapsing rate of the treatment group and the control group (P <0. 05); (3) it has statistical significance of the difference between the adverse reaction rates of the treatment group and the control group (P <0.05); (4) the treatment group' 24hs urine protein is significant lower than the control group' after treatment (P <0. 01) ; (5) the treatment group' complement C3、C4 is significant richer than the control group' after treatment (P<0.01) . (6) compared with the control group the treatment group can be effective in reducing the use of hormones, and the difference between them is very significant(P<0. 01).
[Conclusion] : The treatment group' s effect is better than the control group' s on improving the clinical symptoms, controlling LN recurrence, reducing the incidence of adverse reactions to reduce the use of hormones, lowering urinary protein.
【方法】:将40例轻度活动期的狼疮性肾炎患者按1∶1比例随机分为治疗组和对照组。治疗组在激素治疗的基础上,配合中药辨证加减治疗,对照组单使用激素治疗,观察各组病例中患者纳入时及治疗1年期间临床症状、体征、血常规、补体C3、C4、24h尿蛋白定量、肝肾功能等指标,以观察患者的临床疗效及复发、不良反应发生情况。
【结果】:(1)治疗组总有效率(95.0%)与对照组总有效率(70.0%)相比有显著差异(P＜0.05):(2)治疗组与对照组复发率相比较,差别有统计学意义(P＜0.05);(3)治疗组与对照组不良反应发生率相比较,差别有统计学意义(P＜0.05);(4)治疗组治疗后24h尿蛋白定量下降显著低于对照组(P＜0.01);(5)治疗组治疗后补体C3、C4值显著高于对照组(P＜0.01):(6)治疗组可有效减少激素使用量,与对照组比较有非常显著差别(P＜0.01)。
【结论】:在提高轻度活动期狼疮肾患者的临床疗效、控制LN复发、降低不良反应的发生率、减少激素使用量、降低尿蛋白等方面,中西医结合治疗组疗效优于激素组。
[Purpose] : To observe the clinical effect of the treatment combining traditional Chinese and western medicine on lupus nephritis (LN) in Mildly active and analyze the rate of relapsing , the incidence of adverse reactions.
[Method] : 40 cases of patients with lupus nephritis in Mildly active, randomly divided into treatment and control groups by 1:1 ratio. Treat the conventional treatment group with Chinese medicine Syndrome addition and subtraction on the basis of hormone therapy, and with conventional western medicine treatment for the control group. Observe the treatment of symptoms and signs, blood, complement C3, C4, 24h urine protein, liver and kidney function indicators of patients and analyze the patients' clinical efficacy and recurrence, the occurrence of adverse reactions in each group during one year.
[Results] : (1) There is significant difference between the total efficiency of treatment group (95.0%) and the control group (70.0%) (P <0. 05) ; (2) it has statistical significance of the difference between the relapsing rate of the treatment group and the control group (P <0. 05); (3) it has statistical significance of the difference between the adverse reaction rates of the treatment group and the control group (P <0.05); (4) the treatment group' 24hs urine protein is significant lower than the control group' after treatment (P <0. 01) ; (5) the treatment group' complement C3、C4 is significant richer than the control group' after treatment (P<0.01) . (6) compared with the control group the treatment group can be effective in reducing the use of hormones, and the difference between them is very significant(P<0. 01).
[Conclusion] : The treatment group' s effect is better than the control group' s on improving the clinical symptoms, controlling LN recurrence, reducing the incidence of adverse reactions to reduce the use of hormones, lowering urinary protein.
引文
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[4]朱辟疆.狼疮性肾炎分型分阶段中西医结合治疗[J].中国中西医结合肾病杂志,2003,4,(6):358
[5]蒋季杰主编.现代红斑狼疮病学.北京:人民军医出版社,2005,333-348
[6]张丽红,林琼真.狼疮性肾炎的病理分型进展[J].河北医药2005,27(2):93
[7]张新年.狼疮性肾炎治法初探[J].四川中医,1996,14(10):12
[8]任文英,陈扬荣.补肾清热毒方联合西药治疗狼疮性肾炎的疗效观察[J].北京中医药大学学报,2002,25(3):57-59
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[10]盛梅笑,王身菊.狼疮性肾炎中医临床证候分型的调研分析[J].江苏中医药2004,25(4):12
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[12]苏晓,沈丕安.养阴清热、活血利水为主治疗狼疮性肾炎40例[J].上海中医药杂志,2005,39(1):9-11
[13]王海颖.陈以平教授治疗狼疮性肾炎的经验[J]新中医2001,33(9):9-10
[14]叶任高,任国辉,李惠群,等中西医结合治疗狼疮性肾炎74例疗效观察[J].中国中西医结合杂志,1994,14(6):343
[15]陈严文.叶任高教授中西医结合治疗狼疮性肾炎的经验[J].中国中西医结合肾病杂志,2003,4(2):65-66
[10]卢叶明,黎晓辉,邵洁莹.中西医结合治疗活动性狼疮性肾炎78例疗效观察[J].中国中西医结合肾病杂志,2006,7(3):162-163
[11]余国华,邹丽云.中西医结合治疗活动性狼疮性肾炎28例疗效观察[J].福建中医药,2002,33(4):12-13
[12]杨林,成慧贞.中西医结合治疗狼疮性肾炎36例临床研究[J].河北中医,2003,25(9):698-690
[13]蒋文明,阳晓,叶任高,等狼疮性肾炎尿毒症的中西医结合治疗[J].中国临床医生,2003,31(6):53
[14]李博,汪迅.骁悉联合糖皮质激素治疗难治性狼疮性肾炎的临床观察[J].广东医学院学报,2004,22(4):384
[15]朱辟疆,周逊,赵华,等.中西医结合“二阶段”方案治疗狼疮性肾炎疗效观察.中国中西医结合肾病杂志,2001,2(增刊):1-3
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[17]路建军.激素治疗狼疮性肾炎引发不良反应的中医药调治[J].中国中西医结合肾病杂志,2003,4(5):295-296
[18]吉勤,魏敏.孟如教授治疗狼疮性肾炎的经验[J].云南中医中药杂志,2005,26(3):66
[19]何胜彬,李广然,方敬爱.141例重症狼疮肾炎中西医结合疗效观察[J].中国中西医结合肾病杂志,2001,2(7):401-402
[20]武伟,黄烈诚,叶任高等.狼疮方对狼疮性肾炎活动性和血中透明质酸的作用[J].中国中西医结合肾病杂志,2004,5(5):275-276
[21]陈军宁,尹友生.应用狼疮方中西医结合治疗狼疮肾炎52例疗效观察[J].华夏医学,2001,14(4):509-510
[22]黄访英,刘付捷,苏玉玲.中西医结合治疗活动性狼疮性肾炎32例疗效观察[J].广东医学院学报,2005,23(4):449-450
[23]王林森.中西医结合治疗狼疮性肾炎36例[J].南通医学院学报,2004,24(4):467-468
[24]陈湘君,母小真.补肾固精方治疗狼疮性肾炎的疗效观察[J].上海中医药大学学报,2003,17(1):59
[25]林德就,温伟平.加味猪苓汤配合复方丹参注射液治疗系统性红斑狼疮性肾炎30例疗效观察[J].新中医,2003,35(7):26-27
[26]王济东,赵春荣,郑少同,等.雷公藤多甙对狼疮性肾炎患者血浆IL—13含量的影响.现代中西医结合杂志,2004,13(22):2952-2953
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