百令胶囊联合来氟米特和泼尼松治疗狼疮性肾炎的临床研究
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摘要
目的探究百令胶囊联合来氟米特片和醋酸泼尼松片治疗狼疮性肾炎的临床疗效。方法选取2012年12月—2017年3月开封市中心医院收治的126例狼疮性肾炎患者作为研究对象,按随机原则将患者分为对照组(63例)和治疗组(63例)。对照组患者口服来氟米特片,2片/次,1次/d;同时口服醋酸泼尼松片,1mg/(kg?d),2个月后减量至10mg/d。治疗组在对照组的基础上口服百令胶囊,1g/次,3次/d。两组患者均连续治疗6个月。观察两组患者的临床疗效,同时比较治疗前后两组的白蛋白(ALB)、血肌酐(Scr)、24 h尿蛋白定量(24 h UP)、补体C3、红细胞(RBC)和β2-微球蛋白(β2-MG)水平、系统性狼疮性疾病活动度(SLEDAI)积分。结果治疗后,对照组和治疗组的总有效率分别为79.37%、92.06%,两组比较差异具有统计学意义(P<0.05)。治疗后,两组ALB、补体C3和RBC较治疗前明显升高,而Scr、24 h UP和β2-MG较治疗前明显下降,同组治疗前后比较差异具有统计学意义(P<0.05)。治疗后,治疗组ALB、补体C3和RBC较对照组明显升高,Scr、24hUP和β2-MG较对照组明显下降,两组比较差异具统计学意义(P<0.05)。治疗后,两组SLEDAI积分较治疗前明显下降,同组治疗前后比较差异具有统计学意义(P<0.05);且治疗后,治疗组SLEDAI积分较对照组显著降低,两组比较差异具有统计学意义(P<0.05)。结论百令胶囊联合来氟米特片和醋酸泼尼松片治疗狼疮性肾炎具有较好的临床疗效,可改善肾脏功能,降低狼疮性肾炎活动度和不良反应发生率,具有一定的临床推广应用价值。
Objective To explore the clinical efficacy of Corbrin Capsules combined with Leflunomide Tablets and Prednisone Acetate Tablets in treatment of lupus nephritis. Methods Patients(126 cases) with lupus nephritis in Kaifeng Central Hospital from December 2012 to March 2017 were randomly divided into control(63 cases) and treatment(63 cases) groups. Patients in the control group were po administered with Leflunomide Tablets, 2 tablets/time, once daily. At the same time, they were po administered with Prednisone Acetate Tablets, 1 mg/(kg?d), and reduced to 10 mg/d after 2 month. Patients in the treatment group were po administered with Corbrin Capsules on the basis of the control group, 1 g/time, three times daily. Patients in two groups were treated for 6 month. After treatment, the clinical efficacy was evaluated, and ALB, Scr, 24 h UP, complement C3, RBC, and β2-MG levels, and the SLEDAI scoresin two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the control and treatment group were 79.37% and 92.06%, respectively, and there were differences between two groups(P < 0.05). After treatment, ALB, complement C3, and RBC were significantly increased in two groups, but Scr, 24 h UP, and β2-MG were significantly decreased, and there were differences in the same group(P < 0.05). After treatment, ALB, complement C3, and RBC levels in the treatment group were higher than those in the control group, but Scr, 24 h UP, and β2-MG were lower than those in the control group, and there were differences between two groups(P < 0.05). After treatment, SLEDAI scores in two groups were significantly decreased, and there were differences in the same group(P < 0.05). After treatment, SLEDAI scores in the treatment group were significantly lower than those in the control group, and there were differences between two groups(P < 0.05). Conclusion Corbrin Capsules combined with Leflunomide Tablets and Prednisone Acetate Tablets has clinical curative effect in treatment of lupus nephritis, can improve renal function and reduce activity and incidence of adverse reaction, which has a certain clinical application value.
Objective To explore the clinical efficacy of Corbrin Capsules combined with Leflunomide Tablets and Prednisone Acetate Tablets in treatment of lupus nephritis. Methods Patients(126 cases) with lupus nephritis in Kaifeng Central Hospital from December 2012 to March 2017 were randomly divided into control(63 cases) and treatment(63 cases) groups. Patients in the control group were po administered with Leflunomide Tablets, 2 tablets/time, once daily. At the same time, they were po administered with Prednisone Acetate Tablets, 1 mg/(kg?d), and reduced to 10 mg/d after 2 month. Patients in the treatment group were po administered with Corbrin Capsules on the basis of the control group, 1 g/time, three times daily. Patients in two groups were treated for 6 month. After treatment, the clinical efficacy was evaluated, and ALB, Scr, 24 h UP, complement C3, RBC, and β2-MG levels, and the SLEDAI scoresin two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the control and treatment group were 79.37% and 92.06%, respectively, and there were differences between two groups(P < 0.05). After treatment, ALB, complement C3, and RBC were significantly increased in two groups, but Scr, 24 h UP, and β2-MG were significantly decreased, and there were differences in the same group(P < 0.05). After treatment, ALB, complement C3, and RBC levels in the treatment group were higher than those in the control group, but Scr, 24 h UP, and β2-MG were lower than those in the control group, and there were differences between two groups(P < 0.05). After treatment, SLEDAI scores in two groups were significantly decreased, and there were differences in the same group(P < 0.05). After treatment, SLEDAI scores in the treatment group were significantly lower than those in the control group, and there were differences between two groups(P < 0.05). Conclusion Corbrin Capsules combined with Leflunomide Tablets and Prednisone Acetate Tablets has clinical curative effect in treatment of lupus nephritis, can improve renal function and reduce activity and incidence of adverse reaction, which has a certain clinical application value.
引文
[1]李亚妤,蔡丽丽,黄加力,等.狼疮性肾炎风湿证与肾病理相关性研究[J].中华中医药杂志,2016,31(4):1413-1416.
[2]余娴娴,朱小春,虞旭光,等.来氟米特联合厄贝沙坦治疗狼疮性肾炎的临床疗效和安全性[J].中国生化药物杂志,2016,36(11):62-64.
[3]袁红.狼疮性肾炎的研究进展[J].国际检验医学杂志,2016,37(4):523-526.
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[7]韩履祺.狼疮肾炎的诊断、辨证分型及疗效评定(试行方案)[J].上海中医药杂志,2008,42(2):9-10.
[8]Bombardier C,Gladman D D,Urowitz M B,et al.Derivation of the SLEDAI.A disease activity index for lupus patients.The Committee on Prognosis Studies in SLE[J].Arthritis Rheum,1992,35(6):630-640.
[9]叶彬娴,倪兆慧.狼疮性肾炎的治疗现状及进展[J].中国中西医结合肾病杂志,2012,13(2):167-169.
[10]于晶,张彦,夏燕杰,等.来氟米特联合厄贝沙坦治疗狼疮性肾炎疗效及对肾功能的影响[J].中国地方病防治杂志,2017,32(2):224-225.
[11]张楠,杨洪涛.缬沙坦联合百令胶囊对IgA肾病患者尿蛋白、尿渗透压的影响及其临床安全性的研究[J].西部中医药,2016,29(10):116-118.
[12]陈娣,吴甫民.百令胶囊辅助治疗原发性肾病综合征疗效及对细胞免疫功能、微炎症状态的影响[J].陕西中医,2017,38(12):1670-1672.
[13]王晓阳,王广洁,张晓雪,等.百令胶囊联合他克莫司治疗狼疮性肾炎的临床研究[J].现代药物与临床,2017,32(6):1065-1069.
[14]王伯龄,李庆云,黄维丽.β2-m,Alb,IgG,α1-m联检对肾炎患者肾脏损伤程度的评估[J].放射免疫学杂志,2001,14(2):91-93.
[15]王志伟.尿蛋白/肌酐、24 h尿蛋白及肾功能指标检测在慢性肾病诊断中的临床价值[J].中国处方药,2016,14(3):110-111.
[16]陈俊华,章武战.细胞因子IL-17、IL-22和IL-33与补体C3、补体C4在系统性红斑狼疮患者外周血中的表达及意义[J].中国卫生检验杂志,2018,28(7):849-850.
[17]魏天祥,崔世红,陈娟,等.血清胱抑素C、尿β2-微球蛋白及随机尿微量白蛋白与肌酐比在妊娠期高血压疾病早期肾损伤中的临床应用[J].现代妇产科进展,2018,27(10):485-487.
[2]余娴娴,朱小春,虞旭光,等.来氟米特联合厄贝沙坦治疗狼疮性肾炎的临床疗效和安全性[J].中国生化药物杂志,2016,36(11):62-64.
[3]袁红.狼疮性肾炎的研究进展[J].国际检验医学杂志,2016,37(4):523-526.
[4]郭玉芹,赵卫红.来氟米特联合厄贝沙坦治疗狼疮性肾炎的疗效观察[J].现代药物与临床,2014,29(11):1266-1269.
[5]朱佩君,柯沙沙,徐芳.百令胶囊对狼疮性肾炎患者IL-2、补体及感染率的影响[J].中国现代应用药学,2016,33(3):364-368.
[6]刘文虎.狼疮性肾炎的诊断与治疗[J].中国全科医学,2006,9(2):88-90.
[7]韩履祺.狼疮肾炎的诊断、辨证分型及疗效评定(试行方案)[J].上海中医药杂志,2008,42(2):9-10.
[8]Bombardier C,Gladman D D,Urowitz M B,et al.Derivation of the SLEDAI.A disease activity index for lupus patients.The Committee on Prognosis Studies in SLE[J].Arthritis Rheum,1992,35(6):630-640.
[9]叶彬娴,倪兆慧.狼疮性肾炎的治疗现状及进展[J].中国中西医结合肾病杂志,2012,13(2):167-169.
[10]于晶,张彦,夏燕杰,等.来氟米特联合厄贝沙坦治疗狼疮性肾炎疗效及对肾功能的影响[J].中国地方病防治杂志,2017,32(2):224-225.
[11]张楠,杨洪涛.缬沙坦联合百令胶囊对IgA肾病患者尿蛋白、尿渗透压的影响及其临床安全性的研究[J].西部中医药,2016,29(10):116-118.
[12]陈娣,吴甫民.百令胶囊辅助治疗原发性肾病综合征疗效及对细胞免疫功能、微炎症状态的影响[J].陕西中医,2017,38(12):1670-1672.
[13]王晓阳,王广洁,张晓雪,等.百令胶囊联合他克莫司治疗狼疮性肾炎的临床研究[J].现代药物与临床,2017,32(6):1065-1069.
[14]王伯龄,李庆云,黄维丽.β2-m,Alb,IgG,α1-m联检对肾炎患者肾脏损伤程度的评估[J].放射免疫学杂志,2001,14(2):91-93.
[15]王志伟.尿蛋白/肌酐、24 h尿蛋白及肾功能指标检测在慢性肾病诊断中的临床价值[J].中国处方药,2016,14(3):110-111.
[16]陈俊华,章武战.细胞因子IL-17、IL-22和IL-33与补体C3、补体C4在系统性红斑狼疮患者外周血中的表达及意义[J].中国卫生检验杂志,2018,28(7):849-850.
[17]魏天祥,崔世红,陈娟,等.血清胱抑素C、尿β2-微球蛋白及随机尿微量白蛋白与肌酐比在妊娠期高血压疾病早期肾损伤中的临床应用[J].现代妇产科进展,2018,27(10):485-487.