黄芪注射液联合他克莫司对原发性肾病综合征患者血液黏稠状态、免疫功能及炎症因子的影响

目的 研究黄芪注射液联合他克莫司对原发性肾病综合征患者的治疗效果及对血液黏稠状态的影响。方法 选择2015年1月—2017年10月在西安济仁医院诊治的59例原发性肾病综合征患者，随机分为对照组30例和观察组29例。对照组口服他克莫司胶囊治疗，初始剂量为每天0.1 mg/kg，每天2次，与早餐和晚餐前1 h口服，连续给药6个月；观察组联合静脉滴注黄芪注射液治疗，把40 mL的黄芪注射液溶于250 mL的10%葡萄糖溶液中进行静脉滴注，每天给药1次。两组均连续治疗6个月。比较两组的临床治疗效果、血黏稠度和血小板聚集率，比较两组治疗前后的CD4⁺、CD3⁺、CD8⁺以及CD4⁺/CD8⁺等细胞免疫功能指标和血清白介素-6、肿瘤坏死因子-α以及白介素-23水平。结果 观察组的有效率72.41%明显高于对照组43.33%，差异有统计学意义（P<0.05）。治疗后两组的血小板聚集率和血黏稠度均明显降低，同组治疗前后比较差异有统计学意义（P<0.05）；且观察组明显低于对照组，差异有统计学意义（P<0.05）。两组治疗后的CD4⁺、CD3⁺以及CD4⁺/CD8⁺均升高，同组治疗前后比较差异有统计学意义（P<0.05）；且观察组明显高于对照组，差异有统计学意义（P<0.05）。两组治疗后的白介素-6、肿瘤坏死因子-α以及白介素-23水平均降低，同组治疗前后比较差异有统计学意义（P<0.05）；且观察组明显低于对照组，差异有统计学意义（P<0.05）。结论 黄芪注射液与他克莫司联合使用可以显著提高原发性肾病综合征患者的治疗效果，降低血液高黏状态，控制炎症反应，增强免疫功能，值得应用推广。

Effect of astragalus injection combined with tacrolimus on blood viscosity, immune function and inflammatory factors in patients with primary nephrotic syndrome

Objective To investigate the clinical effect of astragalus injection combined with tacrolimus on blood viscosity in patients with primary nephrotic syndrome.Methods Fifty-nine patients with primary nephrotic syndrome who were treated in our hospital from January 2015 to October 2017 were randomly divided into 30 control groups and 29 observation groups. The control group was treated with Tacrolimus Capsules, and the observation group was treated with intravenous drip of Astragalus injection. The clinical effects of the two groups were compared.Results After treatment, the effective rate of the observation group was 72.41%, which was significantly higher than the control group of 43.33% (P<0.05); the platelet aggregation rate and blood viscosity of the two groups were significantly decreased, and the decrease in the observation group was more obvious (P<0.05); CD4⁺, CD3⁺ and CD4⁺/CD8⁺ in two groups were significantly increased, and the observation group was more obvious (P<0.05); the levels of interleukin - 6, tumor necrosis factor alpha and interleukin -23 in the two groups were significantly decreased, and the observation group was more obvious (P<0.05). Conclusion The combination of Astragalus injection and tacrolimus can significantly improve the therapeutic effect of primary nephrotic syndrome, reduce the blood viscosity, control inflammatory reaction and enhance the immune function, which is worthy of application.