药对黄芪生地配合糖皮质激素治疗狼疮性肾炎的初步临床观察

目的观察药对黄芪生地结合糖皮质激素（GC）治疗狼疮性肾炎（LN）的疗效及对相关实验室指标的影响。方法 52例LN患者随机分为两组,治疗组（25例）在常规西医治疗的基础上加用药对黄芪生地治疗;对照组（27例）以糖皮质激素和环磷酰胺为主的治疗,两组分别观察治疗6个月。记录两组糖皮质激素用量、撤减量及临床疗效、系统性红斑狼疮病情活动指数（SLEDAI）积分、不良反应及实验室指标。结果（1）两组患者病情均得到不同程度缓解,激素能够逐渐减量,治疗组激素撤减量总量（50.23±12.43）mg稍高于对照组（48.76±13.61）mg,差异无统计学意义（P〉0.05）;且治疗组泼尼松用量低于对照组,但差异无统计学意义（P〉0.05）,但治疗组治疗中因病情反复激素需加量的病例比率（16.00%）显著低于对照组（44.44%）,两组比较,差异有统计学意义（P〈0.05）;（2）两组患者治疗后SLEDAI积分,炎症指标,肝、肾功能,血糖,血电解质,血、尿常规比较,差异无统计学意义（P〉0.05）,24 h尿蛋白定量治疗组[（1.06±0.22）g/L]明显低于对照组[（1.43±0.55）g/L],差异有统计学意义（P〈0.05）;（3）两组患者在柯兴综合征、感染、胃肠道出血、精神神经症、心血管异常及股骨头坏死例数方面比较,差异无统计学意义（P〉0.05）,但失眠、潮热、虚汗、肥胖等不良反应发生率治疗组明显低于对照组（P〈0.05）。结论应用黄芪生地配合激素治疗LN,能减少激素的用量及其引起的部分不良反应,有利于激素的撤减和病情的稳定。

Treating Lupus Nephritis by a Drug Pair of Radix Astragali and Rehmanniae Radix Combined with Glucocorticoid. a Preliminary Clinical Study I

Objective To observe the therapeutic effect of a drug pair of Radix Astragali and Re- hmanniae Radix combined with glucocorticoid （GC） in treating lupus nephritis （LN） patients and its influ- ence on some experimental indices. Methods Totally 52 LN patients were randomly assigned to the treatment group （treated by routine Western medicine and a drug pair of Radix Astragali and Rehmanniae Radix, 25 cases） and the control group （treated by Western medicine, mainly by GC and cyclophospha- mide, 27 cases）. All patients received 6-month therapy. The GC dosage, the withdrawal and reduction dosage of GC, clinical efficacy, systemic lupus erythematosus disease activity index （SLEDAI） score, adverse reactions, and laboratory indicators were recorded. Results （1） All patients got relieved to some degree with the dosage of GC reduced. The total withdrawal and reduction dosage of GC was slight- ly higher in the treatment group than in the control group [ （50.23±12.43） mg vs （48.76 ±13.61 ） mg, P 〉0.051. Besides, the prednisone dosage in the treatment group was lower than that in the control group, but without statistical difference （P 〉0.05）. The ratio of patients in need of adding prednisone for aggravating disease was 24.0%, significantly lower than that in the control group （44.44%, P 〈0.05）. （2） There was no statistical difference in the SLEDAI score, inflammatory indicators, liver and renal functions, blood electrolytes, blood glucose, blood and urine routines between the two groups （P 〉0.05）.The 24-h urinary protein count was （1.06 ±0.22） g/L in the treatment group, obviously lower than that in the control group （1.43 ±0.55 g/L, P 〈0.05）. （3） There was no statistical difference in the incidence rate of infection, gastrointestinal hemorrhage, psychoneuroses, Cushing＇s syndrome, cardiovascular a- nomalies, and femoral head necrosis between the two groups （P 〉0.05）. But the incidence of adverse reactions such as insomnia, tidal fever, sponta