| 引用本文:薛丕良1,2，牛雯颖1，李丽琦2，张琳2，肖洪彬1.雷公藤多苷联合小剂量激素治疗特发性膜性肾病的前瞻性对照研究[J].世界中医药,2019,(03):. |
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| 雷公藤多苷联合小剂量激素治疗特发性膜性肾病的前瞻性对照研究 |
| A Prospective Controlled Study of Tripterygium wilfordii Combined with Low Dose Hormone in the Treatment of Idiopathic Membranous Nephropathy |
| 投稿时间：2018-08-14 |
| DOI：10.3969/j.issn.1673-7202.2019.03.028 |
| 中文关键词: 雷公藤多苷 小剂量激素 特发性膜性肾病 血胆固醇 三酰甘油 血尿素氮 血肌酐 临床效果 对照研究 |
| English Keywords:Tripterygium wilfordii polysaccharide Small dose hormone Idiopathic membranous nephropathy Cholesterol Triglyceride Urea nitrogen Serum creatinine Clinical therapeutic effect Controlled study |
| 基金项目:国家自然科学基金面上项目（81473555） |
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| 中文摘要: |
| 目的：探讨雷公藤多苷联合小剂量激素治疗特发性膜性肾病的临床治疗效果。方法：选取2014年8月至2015年11月黑龙江省中医药科学院肾内科收治的特发性膜性肾病患者91例作为研究对象，按照随机数表法随机分为对照组和观察组。对照组给予雷公藤多苷治疗，观察组给予同等雷公藤多苷治疗的基础上再给予小剂量激素治疗。比较2组患者血TC、TG、BUN、SCr、ALB、24 h尿蛋白水平，临床治疗效果，以及治疗后疾病2年累积复发率。结果：治疗后，2组患者血TC、TG、SCr、尿蛋白/24 h水平均显著低于治疗前，血ALB水平均显著高于治疗前；且观察组患者血TC、TG、SCr、尿蛋白/24 h水平均显著低于对照组，血ALB水平均显著高于对照组；以上差异均有统计学意义（P<0.05）。观察组患者治疗总有效率明显高于对照组（χ2=4.561，P=0.033<0.05），且差异有统计学意义（P<0.05）。治疗后观察组特发性膜性肾病患者的2年累积复发率（6.82%，3/44 vs 25.53%，12/47;Log-rank χ2=5.063，P=0.024<0.05）显著低于对照组，且有统计学意义（P<0.05）。结论：雷公藤多苷联合小剂量激素治疗特发性膜性肾病，临床疗效较好，且预后较好，值得在临床推广应用。 |
| English Summary: |
| To investigate the clinical effects of Tripterygium wilfordii combined with low dose hormone in the treatment of idiopathic membranous nephropathy. Methods:In this study，91 patients with idiopathic membranous nephropathy were selected from the nephrology department of Heilongjiang Academy of Traditional Chinese Medicine from August 2014 to November 2015 as the research object，and all the subjects were divided into the observation group and the control group by the random number table method. The control group was treated with tripterygium glycosides，and the observation group was treated with the same dose of Tripterygium wilfordii，and small dose hormone. The serum TC，TG，BUN，SCr，ALB，24 h urinary protein levels，clinical therapeutic effects and cumulative recurrence rate of 2 groups after treatment were compared between the 2 groups. Results:After treatment，the average blood TC，TG，SCr and urine 24 h protein in the 2 groups were significantly lower than those before the treatment，and the blood ALB level was significantly higher than that before the treatment. The average TC，TG，SCr and 24 h urine protein in the observation group was significantly lower than the control group，and the serum ALB level was significantly higher than that in the control group. The difference was statistically significant(P<0.05). The total effective rate of the observation group was significantly higher than that of the control group(χ2=4.561，P=0.033<0.05)，and the difference was statistically significant(P<0.05). After treatment，the cumulative recurrence rate of 2 years in the patients with idiopathic membranous nephropathy(6.82%，3/44 vs 25.53%，12/47，Log-rank χ2=5.063，P=0.024<0.05)was significantly lower than that of the control group，and there was a statistically significant difference(P<0.05). Conclusion:Tripterygium wilfordii combined with low dose hormone in the treatment of idiopathic membranous nephropathy has good clinical curative effects and good prognosis. It is worthy of clinical application. |
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