雷公藤多苷和泼尼松片联合治疗特发性膜性肾病的有效性分析

鲍江波

摘要：目的  研究雷公藤多苷和小劑量激素联合治疗特发性膜性肾病的有效性及可行性。方法  选取2018年10月～2019年10月在我院治疗的108例特发性膜性肾病患者为研究对象，采用随机数字表法分为对照组和观察组，各54例。对照组采用雷公藤多苷治疗，观察组在对照组基础上应用小剂量激素治疗，比较两组临床治疗总有效率、治疗前后24h尿蛋白、血清白蛋白、血尿素氮、胆固醇水平以及临床不良反应发生情况。结果  观察组临床治疗总有效率为92.59%，高于对照组的81.48%，差异有统计学意义（P<0.05）;治疗后两组24h尿蛋白、血尿素氮、胆固醇水平均低于治疗前，血清白蛋白水平均高于治疗前，且观察组优于对照组，差异有统计学意义（P<0.05）;观察组临床不良反应发生率低于对照组，差异有统计学意义（P<0.05）。结论  雷公藤多苷和小剂量激素联合治疗特发性膜性肾病疗效确切，有助于改善肾功能指标及血脂水平，且临床不良反应少，应用安全可行。

关键词：雷公藤多苷;小剂量激素;特发性膜性肾病

中图分类号：R692                                   文献标识码：A                                 DOI：10.3969/j.issn.1006-1959.2020.14.050

文章编号：1006-1959（2020）14-0157-02

Analysis of the Efficacy of Tripterygium Glycosides and Prednisone Tablets

in the Treatment of Idiopathic Membranous Nephropathy

BAO Jiang-bo

（Department of Nephrology，Jiamusi Central Hospital，Jiamusi 154002，Heilongjiang，China）

Abstract：Objective  To study the efficacy and feasibility of combining tripterygium glycosides and low-dose hormone in the treatment of idiopathic membranous nephropathy.Methods  A total of 108 patients with idiopathic membranous nephropathy treated in our hospital from October 2018 to October 2019 were selected as the research object. They were divided into a control group and an observation group with a random number table method， 54 cases each. The control group was treated with tripterygium glycosides， and the observation group was treated with low-dose hormone therapy on the basis of the control group. The total clinical efficacy of the two groups was compared， and the 24h urine protein， serum albumin， blood urea nitrogen， cholesterol level and clinical dysfunction before and after treatment the reaction happened.Results  The total effective rate of clinical treatment in the observation group was 92.59%， which was higher than 81.48% in the control group，the difference was statistically significant （P<0.05）.After treatment， the 24h urine protein， blood urea nitrogen， and cholesterol levels were lower than before treatment， and the serum albumin level was higher than before treatment， and the observation group was better than the control group， the difference was statistically significant （P<0.05）; observation the incidence of clinical adverse reactions in the group was lower than that in the control group，the difference was statistically significant （P<0.05）.Conclusion  The combination of tripterygium glycosides and low-dose hormone in the treatment of idiopathic membranous nephropathy has definite curative effect， which can help to improve the renal function indexes and blood lipid levels.

Key words：Tripterygium glycosides;Low-dose hormone;Idiopathic membranous nephropathy

膜性肾病（membranous nephropathy）是临床常见的疾病，主要以人体肾小球基底膜上皮侧免疫复合物沉积为病理特征，以高蛋白尿、多水肿、高血压、低蛋白血症等肾病综合征症状为临床表现。当前，临床治疗主要给予免疫抑制剂治疗，但是治疗疗效有限，病情不能有效控制，容易进展为肾脏病终末期，严重威胁患者的生命安全。目前，临床采用激素联合免疫抑制剂治疗特发性膜性肾病，以实现多靶点治疗目的[1]。关于雷公藤多苷和泼尼松片联合治疗特发性膜性肾病的研究已有，但是关于其具体的有效性和可行性有待临床进一步证实。本研究结合2018年10月～2019年10月在我院治疗的108例特发性膜性肾病患者临床资料，研究特发性膜性肾病应用雷公藤多苷联合小剂量激素治疗的有效性及可行性，现报道如下。……