清利解毒活血汤联合西药治疗难治性肾病综合征45例疗效观察

目的探讨中西医结合疗法对难治性肾病综合征（RNS）的疗效。方法对45例有病理资料的RNS患者采用清利解毒活血汤联合泼尼松、环磷酰胺治疗，并对病理类型、系膜细胞及肾小管问质损害程度与疗效的关系进行分析。结果45例RNS完全缓解率48．9％，总有效率84．4％。其中系膜增生性肾炎、IgA肾病、局灶性节段性硬化性肾炎及微小病变肾病疗效较好，膜性肾病及膜增殖性肾炎疗效较差，系膜细胞损害程度及肾小管间质损害程度与疗效密切相关。结论清利解毒活血汤联合泼尼松、环磷酰胺对RNS有较好的疗效，但对膜性肾病、膜增殖肾炎以及系膜细胞损害严重或肾小管间质损害严重患者疗效尚不太理想。

Curative effectiveness of qinglijieduhuoxuetang combined with western medicine in the treatment of 45 cases of refractory nephrotic syndrome

Objective To explore the therapeutic effectiveness of integrated chinese-western therapy in the treatment of refractory nephrotie syndrome（RNS）. Methods Forty-five cases of RNS with clinical pathology data were treated with qinglijieduhuoxuetang combined with prednisone and eyclophosphamide,and the relationships between pathologic type, injury degrees of mesangial cells and renal tubule stroma and therapeutic effectiveness were analyzed. Results In 45 eases of RNS, the complete remission rate was 48. 9% ,and the total effective rate was 84. 4%. Among the total cases,more satisfactory effectiveness was obtained in mesangial proliferative nephritis, IgA nephrosis, focal segmental sclerosis and minimal lesion than in membranous nephropathy and membranous productive nephritis. Injury degrees of rnesangial cells and renal tubule stroma were also closely related to therapeutic effectiveness. Conclusion The therapeutic effectiveness of qinglijieduhuoxuetang combined with prednisone and cyclophosphamide is effective to RNS, but not ideal to membranous nephropathy, membranous productive nephritis and serious injury in mesangial ceils or renal tubule stroma.