摘要
目的:观察沈氏清肾汤对阴虚内热型狼疮性肾炎患者尿蛋白及血清B细胞活化因子(B cellactivating factor belong to the TNF family,BAFF)的影响并观察期安全性。方法:将72例阴虚内热型狼疮性肾炎患者随机分为观察组与对照组,每组36例。两组均给予西药醋酸泼尼松片及环磷酰胺基础治疗,观察组在此基础上给予沈氏清肾汤口服,对照组给予安慰剂治疗。治疗6个月后,比较两组患者治疗前后24 h尿蛋白定量、血清BAFF水平、中医证候积分、系统性红斑狼疮疾病活动指数(systemic lupus erythematosus disease activity index,SLE-DAI)、免疫指标[免疫球蛋白G(immunoglobulin G,IgG)、补体C3(complement 3,C3)、补体C4(complement 4,C4)、抗双链DNA(anti double stranded DNA,ds-DNA)]、激素日用量、总有效率及不良反应发生率。结果:两组治疗后均能降低24 h尿蛋白定量、血清BAFF水平、中医证候积分、SLE-DAI、抗ds-DNA及激素日用量,升高补体C3,观察组与对照组相比,差异有统计学意义(P<0.05或P<0.01);两组均能降低IgG、升高补体C4,但差异无统计学意义(P>0.05)。观察组总有效率为84.85%(28/33)、不良反应发生率为3.03%(1/33);对照组总有效率为60.61%(20/33)、不良反应发生率为18.18%(6/33),两组比较,差异均有统计学意义(P<0.05)。结论:沈氏清肾汤能显著降低阴虚内热型LN患者尿蛋白及血清BAFF水平,疗效好、安全性高。
Objective:To observe the effects of Shen′s kidney-clearing decoction on urine protein and serum BAFF in patients with lupus nephritis(LN)of interior heat induced by Yin deficiency pattern and survey its safety.Methods:All 72 patients were randomized into the observation group and the control group,36 cases in each group,both groups were treated by basic therapy of Western medicine prednisone acetate tablets and cyclophosphamide.The observation group orally took Shen′s kidney-clearing decoction and the control group was administered with placebo.To compare 24h urine protein quantification,the levels of serum BAFF,TCM syndrome integrals,SLE-DAI,immunity indexes(IgG,C3,C4 and ds-DNA),daily dosage of hormone,total effective rate and the incidence of adverse reaction before and after treating between both groups after six months of treatment.Results:After the treatment,24h urine protein quantification,the levels of serum BAFF,TCM syndrome integrals,SLE-DAI,anti-ds-DNA and daily dosage of hormone are lowered,and the complement C3 is raised in both groups,when the observation group was compared with the control group,the difference had statistical meaning(P<0.05 or P<0.01);the levels of IgG are lowered and the levels of complement C4 are raised in both groups,while the difference had no statistical meaning(P>0.05).Total effective rate of the observation group was 84.85%(28/33),and the incidence of adverse reaction was 3.03%(1/33);while the rates of the control group were 60.61%(20/33)and 18.18%(6/33),and the difference was statistically significant(P<0.05).Conclusion:Shen′s kidneyclearing decoction could decrease the levels of urine protein and serum BAFF in patients with LN of interior heat induced by Yin deficiency pattern,and it shows good clinical effects and high safety.
作者
姚重华
张娜
顾明珠
黄慧萍
夏嘉
杨旭鸣
陈薇薇
唐华燕
苏晓
沈丕安
YAO Chonghua;ZHANG Na;GU Mingzhu;HUANG Huiping;XIA Jia;YANG Xuming;CHEN Weiwei;TANG Huayan;SU Xiao;SHEN Pi′an(Shanghai City Hospital of Traditional Chinese Medicine,Shanghai 200071,China)
出处
《西部中医药》
2022年第12期129-132,共4页
Western Journal of Traditional Chinese Medicine
基金
上海市自然科学基金项目(19ZR1452300)
上海市科委中医类引导项目(13401904200)
上海市中医药事业发展三年行动计划资助项目(ZYSNXD-CC-MZY048)。
关键词
狼疮性肾炎
沈氏清肾汤
尿蛋白
血清B细胞活化因子
阴虚内热
lupus nephritis
Shen′s kidney-clearing decoction
urine protein
serum BAFF
interior heat induced by Yin deficiency
