固本通络方治疗激素抵抗型难治性肾病综合征临床研究

目的观察固本通络方治疗激素抵抗型难治性肾病综合征(SRNS)的临床疗效并探讨其作用机制。方法将70例SRNS患者随机分为2组,对照组35例应用西医常规治疗,治疗组35例在对照组治疗基础上应用固本通络方治疗。2组均治疗3个月,观察2组治疗前后中医临床症状、体征改善情况,比较中医证候积分、24 h尿蛋白定量、肾功能损伤指标、血脂指标及凝血功能指标等变化情况,对比分析2组不良反应发生率。结果治疗组总有效率94.29%,优于对照组(77.14%,P0.05)。治疗组治疗后中医临床症状、体征改善率均优于对照组(P0.05);治疗组治疗后中医证候积分、总胆固醇(TC)、甘油三酯(TG)、24 h尿蛋白定量、胱抑素C(Cys C)、血浆纤维蛋白原(FIB)及血浆D-二聚体(DD)较治疗前均降低,血浆白蛋白(Alb)升高,差异均有统计学意义(P0.05),且改善情况均优于对照组(P0.05)。2组治疗后尿素氮(BUN)、血肌酐(Cr)及尿酸(UA)较治疗前均无明显改善(P0.05)。治疗组不良反应发生率(28.57%)低于对照组(62.86%,P0.05)。结论固本通络方可能通过多种调节机制,具有一定治疗SRNS的作用,临床安全有效,值得进一步研究。

Clinical observation of Guben - tongluo formula on the treatment of refractory steroid - resistant nephrotic syndrome

Objective To observe the clinical effect of Guben - tongluo formula on the treatment of refractory steroid - resistant nephrotic syndrome(SRNS)and explore its mechanism of effect. Methods 70 refractory SRNS patients were randomly divided into two groups. 35 patients in control group were treated by western routine treat-ment. 35 patients in treatment group were treated by Guben - tongluo formula on the basis of control group treatment. The course was three months in two groups. The improvements of traditional Chinese medicine(TCM)symptoms and physical sign were observed in two groups. The TCM syndrome score,24 h urine protein excretion,renal injury in-dex,blood lipid parameter and coagulation parameters before and after treatment were compared. The adverse reac-tion rate was compared between two groups. Results The total effective rate in treatment group(94. 29% )was su-perior to that in control group(77. 14% ,P ﹤ 0. 05). The improvement rates of TCM symptoms and physical sign af-ter treatment in treatment group were superior to those in control group(P ﹤ 0. 05). The TCM syndrome score,total cholesterol(TC),triglyceride(TG),24 h urine protein excretion,cystatin C(CysC),plasma fibrinogen(FIB) and plasma D dimmer(DD)after treatment in treatment group were decreased,and the plasma albumin(Alb)was increased,there were statistical significances(P ﹤ 0. 05). The improvements in treatment group were superior to those in control group(P ﹤ 0. 05). There was little improvement on urea nitrogen(BUN),serum creatinine(Cr) and uric acid( UA)after treatment in two groups( P ﹤ 0. 05). The adverse reaction rate in treatment group (28. 75% )was lower than that in control group(62. 86% , P ﹤ 0. 05). Conclusion Guben - tongluo formula has some kind of therapeutic effect on SRNS through multiple mecha-nisms,safe and effective,deserve further study.