环磷酰胺联合大剂量黄芪注射液静脉滴注治疗狼疮性肾炎

目的:观察环磷酰胺加大剂量黄芪注射液静滴对狼疮性肾炎患者的感染、尿蛋白以及免疫功能等方面的影响。方法:共选择43例系统性红斑狼疮(systemic lupus erythematosus,SLE)患者,均符合SLE诊断标准且伴有不同程度肾脏损害,中医辨证属气虚型。将其随机分为治疗组23例,对照组20例。治疗组用0.8 g环磷酰胺静脉滴注1次/月,并静滴黄芪注射液20 ml,1次/d,连续12 d,休息18 d。对照组单用环磷酰胺0.8 g静脉滴注,1次/月。两组每个疗程均为30 d,连续观察3个疗程。结果:治疗组治疗后活动性临床症状积分的下降程度优于对照组(P<0.05)。治疗组感染率为4.35%,对照组感染率为25%。经过3个疗程的治疗,治疗组24 h尿蛋白、CD8、红细胞及白蛋白等生化指标,与对照组比较,差异有统计学意义(P<0.05)。治疗组白细胞水平在治疗后虽有下降,但幅度明显小于对照组(P<0.05)。结论:大剂量黄芪注射液加环磷酰胺静脉滴注治疗狼疮性肾炎在降低感染发生率和尿蛋白以及改善患者免疫功能等方面优于单用环磷酰胺。

Effect of intravenous drip infusion of cyclophosphamide with high-dose Astragalus injection in treating lupus nephritis

Objective: To observe the effect of high-dose Astragalus injection and cyclophosphamide(CTX) on infection,urine protein and immune function of the patients with lupus nephritis.Methods: Forty-three patients diagnosed as systemic lupus erythematosus(SLE) complicated by kidney damage and qi-deficiency syndrome were randomly divided into trial group(n=23) and control group(n=20).Patients in both groups were treated for 3 months.Intravenous drip infusion of 0.8 g CTX was administered to all patients once a month,while intravenous drip infusion of 20 ml Astragalus injection was only administered to patients in the trial group every day for 12 days in each month.Results: The decrease of active clinical symptom score after the treatment in the trial group was greater than that in the control group(P<0.05).The infection rates of the trial group and the control group were 4.35% and 25% respectively.The decrease of 24-hour urine protein and CD8,and the increase of red blood cell count and serum albumin in the trial group were greater than those in the control group,and there were significant differences between the two groups(P<0.05).White blood cell count in the trial group was decreased less than that in the control group after the treatment(P<0.05).Conclusion: High-dose Astragalus injection used together with CTX is more effective than CTX alone in decreasing infection rate and urine protein and improving immune function for patients with lupus nephritis.