金芪膜腎方聯(lián)合雷公藤多苷片治療特發(fā)性膜性腎病療效觀察
發(fā)布時(shí)間：2018-11-23 08:53
【摘要】：目的：以環(huán)磷酰胺(CTX)治療作對(duì)照組,觀察金芪膜腎方聯(lián)合雷公藤多苷片(TW)治療特發(fā)性膜性腎病(IMN)的臨床療效,探討中醫(yī)治療IMN的手段與治療機(jī)制。方法：2014年03月至2015年12月江蘇省中醫(yī)院門診及住院患者共40例,符合IMN診斷條件,分為治療組與對(duì)照組各20例,在糖皮質(zhì)激素、ACEI/ARB、控制血壓、調(diào)脂等治療基礎(chǔ)上,治療組予金芪膜腎方聯(lián)合TW,對(duì)照組予CTX,平均觀察時(shí)間為6個(gè)月,觀察治療前后兩組24hUTP、Scr、Alb、TC、TG、LDL-C、WBC、ALT、AST指標(biāo)的變化及不良反應(yīng)。結(jié)果：①疾病綜合療效：治療組完全緩解2例(10%),部分緩解14(70%)例,未緩解4例(20%),總有效率為80%；對(duì)照組完全緩解4例(20%),部分緩解13(65%)例,未緩解3例(15%),總有效率為85%,差別無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。②中醫(yī)證候療效：治療組與對(duì)照組總有效率分別為90%、60%,差別有統(tǒng)計(jì)學(xué)意義(P0.01),治療組療效優(yōu)于對(duì)照組。③蛋白尿：治療第3、6個(gè)月后兩組患者24hUTP較治療前均顯著下降(P0.01),組間比較差別無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。④Scr：治療組Scr差別有統(tǒng)計(jì)學(xué)意義(P0.05),對(duì)照組Scr差別無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。⑤其他實(shí)驗(yàn)室指標(biāo)：兩組血Alb均得到顯著改善(P0.01)；治療組改善更明顯,組間比較差別有統(tǒng)計(jì)學(xué)意義(P0.05)。兩組Scr比較差別無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。治療前后兩組血脂(TC、TG、LDL-C)差別均有統(tǒng)計(jì)學(xué)意義(P0.05),治療組TG較對(duì)照組改善更明顯,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。⑥癥狀積分：治療后兩組中醫(yī)癥狀總積分均有下降,治療組下降更明顯,組內(nèi)及組間比較差異均有統(tǒng)計(jì)學(xué)意義(P0.01)；治療組患者水腫、腰酸腰痛、食少納呆、疲乏癥狀積分較治療前下降,與對(duì)照組相比,組內(nèi)及組間比較差異均有統(tǒng)計(jì)學(xué)意義(P0.01)。⑦安全性指標(biāo)：兩組患者安全性指標(biāo)(WBC、ALT、AST)、總體不良反應(yīng)差異均無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論：在西醫(yī)常規(guī)及中醫(yī)辨證的基礎(chǔ)上,金芪膜腎方聯(lián)合TW在降低蛋白尿、穩(wěn)定腎功能方面與CTX療效相當(dāng),在中醫(yī)證候方面優(yōu)于CTX,不良反應(yīng)少。
[Abstract]:Objective: to observe the clinical effect of Jinqi membrane-kidney prescription combined with tripterygium polyglycoside (TW) in the treatment of idiopathic membranous nephropathy (IMN) with cyclophosphamide (CTX) as the control group, and to explore the means and mechanism of TCM treatment of IMN. Methods: from March 2014 to December 2015, a total of 40 outpatients and inpatients in Jiangsu Provincial Hospital of traditional Chinese Medicine were divided into treatment group (n = 20) and control group (n = 20). On the basis of glucocorticoid, ACEI/ARB, to control blood pressure and regulate lipid, etc. The average observation time of CTX, was 6 months in the treatment group treated with Jin Qi Mian Shen Fang and TW, control group. The changes and adverse reactions of the two groups were observed before and after treatment. Results: 1 Comprehensive curative effect: 2 cases (10%) with complete remission, 14 cases (70%) with partial remission and 4 cases (20%) with no remission in the treatment group. The total effective rate was 80%. In the control group, there were 4 cases (20%) with complete remission, 13 cases (65%) with partial remission and 3 cases (15%) with no remission. The total effective rate was 85%. 2 the curative effect of TCM syndrome: the total effective rate of treatment group and control group were 90 and 60, respectively, the difference was statistically significant (P0.01). The curative effect of the treatment group was better than that of the control group. 3. The 24hUTP of the two groups was significantly lower than that of the control group (P0.01) after 3 months and 6 months of treatment (P0.01). There was no significant difference between the two groups (P0.05). 4Scr4: the difference of Scr in the treatment group was statistically significant (P0.05). The difference of Scr in the control group was not statistically significant (P0.05). 5 other laboratory indicators: the two groups of blood Alb were significantly improved (P0.01); The improvement of treatment group was more obvious, the difference between groups was statistically significant (P0.05). There was no significant difference in Scr between the two groups (P0.05). There were significant differences in blood lipid (TC,TG,LDL-C) between the two groups before and after treatment (P0.05). TG in the treatment group was significantly improved than that in the control group. The difference was statistically significant (P0.05). 6 symptom score: after treatment, the total score of TCM symptoms in the two groups were all decreased, the decrease in the treatment group was more obvious, and the difference between the groups was statistically significant (P0.01). In the treatment group, the scores of edema, low back pain, low appetite and fatigue symptoms were lower than those before treatment, compared with those in the control group. There were significant differences within and between groups (P0.01). 7 Safety indicators: the two groups of patients with safety indicators (WBC,ALT,AST), the overall adverse reactions were not statistically significant (P0.05). Conclusion: on the basis of western medicine routine and TCM syndrome differentiation, Jinqi membrane-kidney prescription combined with TW can reduce proteinuria and stabilize renal function as well as CTX, and has less adverse reactions than CTX, in TCM syndromes.
【學(xué)位授予單位】：南京中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2016
【分類號(hào)】：R277.5
[Abstract]:Objective: to observe the clinical effect of Jinqi membrane-kidney prescription combined with tripterygium polyglycoside (TW) in the treatment of idiopathic membranous nephropathy (IMN) with cyclophosphamide (CTX) as the control group, and to explore the means and mechanism of TCM treatment of IMN. Methods: from March 2014 to December 2015, a total of 40 outpatients and inpatients in Jiangsu Provincial Hospital of traditional Chinese Medicine were divided into treatment group (n = 20) and control group (n = 20). On the basis of glucocorticoid, ACEI/ARB, to control blood pressure and regulate lipid, etc. The average observation time of CTX, was 6 months in the treatment group treated with Jin Qi Mian Shen Fang and TW, control group. The changes and adverse reactions of the two groups were observed before and after treatment. Results: 1 Comprehensive curative effect: 2 cases (10%) with complete remission, 14 cases (70%) with partial remission and 4 cases (20%) with no remission in the treatment group. The total effective rate was 80%. In the control group, there were 4 cases (20%) with complete remission, 13 cases (65%) with partial remission and 3 cases (15%) with no remission. The total effective rate was 85%. 2 the curative effect of TCM syndrome: the total effective rate of treatment group and control group were 90 and 60, respectively, the difference was statistically significant (P0.01). The curative effect of the treatment group was better than that of the control group. 3. The 24hUTP of the two groups was significantly lower than that of the control group (P0.01) after 3 months and 6 months of treatment (P0.01). There was no significant difference between the two groups (P0.05). 4Scr4: the difference of Scr in the treatment group was statistically significant (P0.05). The difference of Scr in the control group was not statistically significant (P0.05). 5 other laboratory indicators: the two groups of blood Alb were significantly improved (P0.01); The improvement of treatment group was more obvious, the difference between groups was statistically significant (P0.05). There was no significant difference in Scr between the two groups (P0.05). There were significant differences in blood lipid (TC,TG,LDL-C) between the two groups before and after treatment (P0.05). TG in the treatment group was significantly improved than that in the control group. The difference was statistically significant (P0.05). 6 symptom score: after treatment, the total score of TCM symptoms in the two groups were all decreased, the decrease in the treatment group was more obvious, and the difference between the groups was statistically significant (P0.01). In the treatment group, the scores of edema, low back pain, low appetite and fatigue symptoms were lower than those before treatment, compared with those in the control group. There were significant differences within and between groups (P0.01). 7 Safety indicators: the two groups of patients with safety indicators (WBC,ALT,AST), the overall adverse reactions were not statistically significant (P0.05). Conclusion: on the basis of western medicine routine and TCM syndrome differentiation, Jinqi membrane-kidney prescription combined with TW can reduce proteinuria and stabilize renal function as well as CTX, and has less adverse reactions than CTX, in TCM syndromes.
【學(xué)位授予單位】：南京中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2016
【分類號(hào)】：R277.5
【相似文獻(xiàn)】
相關(guān)期刊論文 前10條
1 余學(xué)清,楊瓊瓊;特發(fā)性膜性腎病的治療[J];中國(guó)實(shí)用內(nèi)科雜志;2003年05期
2 周仲昊,朱蘊(yùn)秋;膜性腎病的臨床病理與預(yù)后的關(guān)系[J];齊齊哈爾醫(yī)學(xué)院學(xué)報(bào);2003年05期
3 王太華,李清初,于克波;足細(xì)胞與膜性腎病[J];中國(guó)中西醫(yī)結(jié)合腎病雜志;2004年06期
4 草X4哲郎 ,李勝;膜性腎病[J];日本醫(yī)學(xué)介紹;2005年09期
5 梁世凱;許菲菲;舒桂琴;呂吟秋;邵蓉蓉;劉毅;;70例特發(fā)性膜性腎病的臨床特點(diǎn)和治療探討[J];中國(guó)中西醫(yī)結(jié)合腎病雜志;2006年10期
6 朱虎章;;膜性腎病并發(fā)成人呼吸窘迫綜合征1例救治體會(huì)[J];中國(guó)中西醫(yī)結(jié)合腎病雜志;2007年03期
7 陳以平;鄧躍毅;;特發(fā)性膜性腎病[J];中國(guó)中西醫(yī)結(jié)合腎病雜志;2007年08期
8 舒桂琴;許菲菲;梁世凱;劉毅;呂吟秋;邵蓉蓉;;51例成人特發(fā)性膜性腎病的治療觀察[J];浙江預(yù)防醫(yī)學(xué);2007年10期
9 何志軍;楊琪;周柱亮;;膜性腎病136例分析[J];人民軍醫(yī);2007年11期
10 黃少珍;唐德q，
本文編號(hào)：2350971
本文鏈接：http://sikaile.net/zhongyixuelunwen/2350971.html
最近更新
教材專著
