宣肺利水汤治疗特发性膜性肾病临床疗效观察

目的 宣肺利水汤治疗特发性膜性肾病初步疗效评价及对抗PLA2R抗体的影响。方法 将57例表现为肾病综合征的特发性膜性肾病患者随机分为对照组28例和治疗组29例。两组患者西医治疗方案相同,地塞米松针10mg静滴每日1次,治疗2周,后改强的松片1mg/kg口服每日1次,治疗4周。治疗组同时加用中药宣肺利水汤,疗程6周。观察两组患者治疗前后尿量、体重、24h尿蛋白、血白蛋白、血清抗PLA2R抗体及中医证候的变化。并记录两组不良反应事件。结果 治疗组增加尿量、下降体重均优于对照组,差异有统计学意义(P＜0.05),治疗组24h尿蛋白下降、血白蛋白上升均优于对照组,差异有统计学意义(P＜0.01)。治疗组血清抗PLA2R滴度较对照组明显下降,差异有统计学意义(P＜0.05)。治疗组在水肿、肢体困重、大便溏薄、小便短少方面较治疗前明显改善,差异有统计学意义(P＜0.05),治疗组治疗前后证候总积分减少33.3%,证候疗效判断为有效。治疗组不良反应发生率为6.9%,对照组不良反应发生率为21.4%,两组比较差异有统计学意义(P＜0.05)。 结论 中药宣肺利水汤治疗特发性膜性肾病具有提高疗效、降低不良反应的作用。

To evaluate the preliminary efficacy of xuanfeilishui soup in the treatment of Idiopathic membranous nephropathy and its impact on the PLA2R antibody ZHENG Min-wei, TAO Xiao-juan, ZHENG Hong-xia. Department of Nephrology, Zhejiang Chinese and Western medicine hospital, Hangzhou (310003), China

Objective To evaluate the preliminary efficacy of xuanfeilishui soup in the treatment of Idiopathic membranous nephropathy and its impact on the PLA2R antibody. Methods The 57 patients with Idiopathic membranous nephropathy presenting as Nephrotic syndrome were randomly divided into the control group and the treatment group. The two groups of patients were treated with the same treatment regimen, with 10mg of dexamethasone injection for 2 weeks daily, and 1mg/kg of prednisolone tablets per day for oral treatment. The treatment group was also treated with xuanfeilishui soup for 6 weeks. The changes of urine volume, body weight, 24-hour urine protein, serum albumin, serum anti-PLA2R antibody and TCM syndromes were observed before and after treatment. Two groups of adverse events were recorded. Results After six weeks of treatment, compared before and after treatment, the level of increased urine and reduced weight in the treatment group were better than those in the control group, the difference was statistically significant (P<0.05), the level of decreased 24-hour urine protein and elevated blood albumin in the treatment group were better than those in the control group, the difference was statistically significant (P<0.01). The titer of PLA2R antibody in the treatment group was significantly lower than that in the control group, the difference was statistically significant (P<0.05). The symptoms of traditional Chinese medicine in edema, body fatigue, Shit viscous, urination difficult were obviously improved, the difference was statistically significant (P<0.05), the total score of syndromes in the treatment group decreased by 33.3% before and after treatment, and the therapeutic effect of syndromes was judged to be effective. The incidence of adverse reactions was 6.9% in the treatment group and 21.4% in the control group, and the difference between the two groups was statistically significant (P<0.05). Conclusion Traditional Chinese medicine xuanfeilishui soup in treating Idiopathic membranous nephropathy has improved curative effect and reduced adverse reaction.