摘要
目的:评价结合祛风活血吗替麦考酚酯(MMF)联合小剂量激素治疗伴活动性增生病变Ig AN的有效性和安全性。方法:将60例患者随机分为两组,A组:MMF联合小剂量激素(0.4~0.6 mg·kg^-1·qod^-1),B组:半剂量激素(0.4~0.6 mg·kg^-1·qd^-1),两组均给予祛风活血方,疗程24周。观察治疗前后血常规、肝功能、血糖、与药物相关的不适主诉和尿蛋白定量、血浆白蛋白、血肌酐。结果:治疗后A组总有效率83.3%,完全缓解率26.7%,B组总有效率76.7%,完全缓解率23.3%,两组差异无统计学意义(P>0.05)。治疗3个月后,两组尿蛋白定量下降,A组较B组下降明显(P<0.05),两组血浆白蛋白水平均升高、血肌酐水平均下降,但差异无统计学意义(P>0.05)。治疗6个月后,两组尿蛋白定量进一步下降,但组间差异无统计学意义(P>0.05),两组血浆白蛋白水平继续升高,A组较B组升高明显(P<0.05),两组血肌酐进一步下降,但组间差异无统计学意义(P>0.05)。A组仅少量且轻度的不良反应,而B组药物不良反应发生率明显较高、较重。结论:结合祛风活血MMF联合小剂量激素治疗伴活动性增生病变Ig A肾病可明显降低蛋白尿、升高血浆白蛋白、减轻肾脏损伤,不良事件发生率低,是一种可供临床选用的治疗方案。
Objective:To evaluate the efficacy and safety of the combination of Qufeng Huoxue therapy and MMF combined with low-dose hormones in the treatment of Ig AN with active hyperplasia.Methods:Sixty patients were randomly divided into two groups.Group A:MMF combined with low-dose hormones(0.4~0.6 mg·kg^-1·qod^-1).Group B:half-dose hormones(0.4~0.6 mg·kg^-1·qd^-1).Those two groups were given Qufeng Huoxue Fang for 24 weeks.Observe blood routine,liver function,blood sugar,complaints about drug-related discomfort,urine protein quantification,plasma albumin,and serum creatinine before and after treatment.Results:After treatment,the total effective rate of group A was 83.3%,and the complete response rate was26.7%.The total effective rate of group B was 76.7%,and the complete response rate was 23.3%.There was no significant difference between the two groups(P>0.05).After 3 months of treatment,the quantitative changes of urinary protein in the two groups decreased significantly in group A compared with group B(P<0.05).Plasma albumin levels increased and blood creatinine levels decreased in both groups,but the differences were not statistically significant(P>0.05).After 6 months of treatment,the urinary protein in the two groups decreased further,but the difference between the groups was not statistically significant(P>0.05).Plasma albumin levels in the two groups continued to increase,and the increase in group A was significantly higher than that in group B(P>0.05).The serum creatinine of the two groups decreased further,but there was no significant difference between the groups(P>0.05).Group A had only small and mild adverse reactions,while group B had significantly higher and more serious adverse reactions.Conclusion:Combining Qufeng Huoxue therapy,MMF with low-dose hormone treatment for Ig A nephropathy with active proliferative lesions can significantly reduce proteinuria,increase plasma albumin,reduce kidney damage,and has a low incidence of adverse events.It is a treatment available for clinical use program.
作者
徐业
徐秀琴
娄成利
赵俊
黄科
王向晶
胡平新
王汉岑
XU Ye;XU Xiuqin;LOU Chengli(Jiaxing Hospital of Traditional Chinese Medicine Affiliated to Zhejiang University of Traditional Chinese Medicine,Jiaxing(314000))
出处
《中国中西医结合肾病杂志》
2020年第9期776-779,共4页
Chinese Journal of Integrated Traditional and Western Nephrology
基金
浙江省嘉兴市科技局科研基金资助项目(No.2018AD32150)。
