發(fā)布時間：2018-06-21 02:57

  本文選題：腎病綜合征 + 百令膠囊�。� 參考：《湖北科技學院》2017年碩士論文

【摘要】：目的通過建立阿霉素腎病動物模型和收集腎病綜合征患者資料,來從動物實驗和臨床試驗兩個方面來觀察百令膠囊輔助治療腎病綜合征的療效。方法1.動物實驗:選用雄性SD大鼠,尾靜脈注射阿霉素(ADR)4mg/kg,一周后改為2mg/kg。3周后取20只正常大鼠及60只造模成功的大鼠(測尿蛋白定量大于100mg/24h即造模成功),模型大鼠隨機分為3組,后分別給藥治療。(1)正常對照組20只:正常飼養(yǎng),不做特殊處理。(2)模型對照組20只:2ml生理鹽水灌胃,每日一次。(3)潑尼松組20只:潑尼松2.5mg/kg與2ml生理鹽水配置成混懸液灌胃,每日一次。(4)聯(lián)合治療組(D組)20只:用百令膠囊內(nèi)容物350mg/kg和醋酸潑尼松2.5mg/kg與2ml生理鹽水配制成混懸液灌胃,每日一次。給藥4周觀察大鼠24小時尿蛋白定量、血脂、血漿總蛋白(TP)、血白蛋白(ALB)、尿素氮(BUN)、肌酐(Scr)水平。2.臨床試驗:抽取收治的腎病綜合征患者44例,觀察組和對照組各22例。兩組均予一般對癥治療(包括適當休息,低飽和脂肪、少鹽、適量蛋白飲食及對癥治療)。(1)對照組予標準激素治療方案,醋酸潑尼松起始劑量為1.0mg/(kg.d),最大用量不超過60mg/d,每日晨起頓服,連續(xù)服用8周,足量治療后每1-2周減原用量的10%,減至20 mg/d時維持2~3個月,以后每14天減2.5~5mg,最后以最小有效劑量(10mg/d)作為維持量。(2)觀察組基于對照組基礎上加用百令膠囊,每次3粒(1.5g),3次/d,口服。治療后1、3、6個月觀察患者24小時尿蛋白定量、血脂、血漿總蛋白(TP)、血白蛋白(ALB)、尿素氮(BUN)、肌酐(Scr)水平及患者水腫情況。結果1、動物實驗(1)與正常對照組相比,模型對照組24小時尿蛋白定量、血肌酐、尿素氮、甘油三酯、總膽固醇較高,血總蛋白、血白蛋白值較低,各項指標差異均具有統(tǒng)計學意義。(2)與模型對照組相比,醋酸潑尼松組24小時尿蛋白定量、血肌酐較低,血總蛋白、血白蛋白值較高,差異具有統(tǒng)計學意義(3)與模型對照組相比,醋酸潑尼松+百令膠囊內(nèi)容物組24小時尿蛋白定量、血肌酐、尿素氮、甘油三酯、總膽固醇較低,血總蛋白、血白蛋白值較高,差異具有統(tǒng)計學意義。(4)與醋酸潑尼松組比較,加用百令膠囊內(nèi)容物的聯(lián)合治療組各項生化指標更接近正常對照組值。24小時尿蛋白定量、甘油三酯、總膽固醇較低,血白蛋白值較高,差異具有統(tǒng)計學意義。其余指標無統(tǒng)計學差異。2、臨床試驗與對照組相比,觀察組的24小時尿蛋白定量、甘油三酯、總膽固醇降低更明顯,血漿總蛋白(TP)、血白蛋白(ALB)升高更明顯。與對照組相比,觀察組患者復發(fā)率更低,總有效率更高。結論百令膠囊輔助治療NS效果優(yōu)于單獨使用醋酸潑尼松。
[Abstract]:Objective to establish the animal model of adriamycin nephropathy and collect the data of patients with nephrotic syndrome to observe the therapeutic effect of bailing capsule on nephrotic syndrome from two aspects: animal experiment and clinical trial. Method 1. Animal experiment: male SD rats were injected with adriamycin (adriamycin) 4 mg / kg via tail vein. After one week, 20 normal rats and 60 successful rats were selected for 2mg/kg.3 week. The rats were randomly divided into 3 groups. Then 20 rats in normal control group: normal feeding, no special treatment, 20 rats in model control group were perfused with 2 ml normal saline, once a day, 20 rats in prednisone group: prednisone 2.5mg/kg and 2ml normal saline were used as suspension perfused intragastrically, and the control group (n = 20) was treated with prednisone (n = 20), and the control group (n = 20) was perfused with normal saline (n = 20, n = 20). Group D (n = 20): suspension was made with 350mg/kg, prednisone acetate 2.5mg/kg and 2ml normal saline, once a day. After 4 weeks of administration, the levels of 24 hours urine protein, blood lipid, total plasma protein (TPN), serum albumin (ALBN), bun (bun), creatinine (SCR) were observed. Clinical trial: 44 cases of nephrotic syndrome, 22 cases of observation group and 22 cases of control group. Both groups were treated with general symptomatic therapy (including proper rest, low saturated fat, low salt, protein diet and symptomatic therapy). The control group was treated with standard hormone therapy. The initial dose of prednisone acetate was 1.0 mg / L / kg 路dL, the maximum dose was not more than 60 mg / d, taken daily in the morning, continuously for 8 weeks. After full treatment, 10% of the original dose was reduced every 1-2 weeks to 20 mg/d for 2 ~ 3 months. After 14 days, 2.5 mg / d was reduced, followed by a minimum effective dose of 10 mg / d as the maintenance dose.) in the observation group, bailing capsule was added on the basis of the control group, 3 tablets of 1. 5 mg / d each time, and taken orally for 3 / d of 1. 5 mg / d. The levels of 24 hour urine protein, serum lipids, plasma total protein (TPN), serum albumin (ALBN), bun (bun), creatinine (SCR) and edema were observed at 1 and 6 months after treatment. Results 1. Compared with the normal control group, the model control group had higher serum creatinine, urea nitrogen, triglyceride, higher total cholesterol and lower serum albumin. Compared with the model control group, the serum creatinine, total protein and albumin in prednisone acetate group were significantly higher than those in the model control group. Serum creatinine, urea nitrogen, triglyceride, total cholesterol, serum total protein and serum albumin were higher in prednisone acetate group (P < 0.05) and compared with prednisone acetate group (P < 0.05). The biochemical indexes of the combined treatment group were closer to the normal control group. 24 hours urine protein quantitative, triglyceride, total cholesterol was lower, the serum albumin value was higher, the difference was statistically significant. Compared with the control group, the 24 hour urinary protein quantity, triglyceride and total cholesterol in the observation group were lower than those in the control group, and the levels of TPN and ALB in plasma were higher in the observation group than in the control group. Compared with the control group, the recurrence rate was lower and the total effective rate was higher in the observation group. Conclusion Bering capsule is superior to prednisone acetate alone in the treatment of NS.
【學位授予單位】：湖北科技學院
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R692

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