自拟益肾固元汤结合醋酸泼尼松片治疗肾病综合征临床研究

目的：评价自拟益肾固元汤结合醋酸泼尼松片治疗肾病综合征的疗效。方法将符合入选标准的160例肾病综合征患者按随机数字表法分为2组，每组80例。对照组在常规治疗基础上口服醋酸泼尼松片，观察组在对照组基础上加服自拟益肾固元汤。2组均治疗6个月。采用全自动生化分析仪检测IL-6、TNF-α、血肌酐、血尿素氮、血浆白蛋白，收集24 h尿液，检测24 h尿蛋白定量，评价临床疗效及不良反应发生率。结果观察组总有效率为92.5%(74/80)、对照组为82.5%(58/80)，2组比较差异有统计学意义(χ2＝5.521，P＜0.05)。治疗后，观察组血清 IL-6(69.36±12.96)ng/ml 比(97.58±14.25)ng/ml,t＝-4.965]、TNF-α(107.32±30.23)pg/ml 比(145.25±23.28)pg/ml,t＝-6.235]水平低于对照组(P＜0.05)；24 h尿蛋白定量(0.59±0.25)g/24 h比(1.23±0.36)g/24 h,t＝5.263]低于对照组(P＜0.05)，血清白蛋白(41.25±3.69)g/L比(33.25±3.36)g/L,t＝9.582]和总蛋白(64.25±2.36)g/L比(51.23±2.21)g/L,t＝11.365]高于对照组(P＜0.05)。结论自拟益肾固元汤结合醋酸泼尼松片可降低肾病综合征患者炎症因子水平，恢复肾功能，降低尿蛋白，疗效优于单纯西药治疗。

Study on the effectiveness and safety of the treatment of prednisone combined with self-made Yishen-Guyuan decoction on the patients with nephrotic syndrome

Objective To observe the effect ofYishen-Guyuan decoction combined with prednisone tablets in the treatment of the patients with nephrotic syndrome.Methods A total of 160 patients with nephrotic syndrome were randomly divided into two groups. On the basis of routine treatment, the control group received oral prednisone tablets treatment. On the basis of control group, the observation group also received Yishen-Guyuan decoction. Two groups were treated for 6 months. Full automatic biochemical analyzer was used to detect IL-6, TNF-α, serum creatinine, blood urea nitrogen, plasma albumin, collected 24 h urine, detection of 24 h urine protein quantitation, evaluation of clinical efficacy and adverse reaction rate.Results The total effective rate of the observation group was 92.5% (74/80), and the control group was 82.5% (58/80). The difference between the two groups was statistically significant (χ2=5.521,P<0.05). After treatment, the serum levels of IL-6 (69.36 ± 12.96 ng/mlvs.97.58 ± 14.25 ng/ml,t=-4.965), TNF-α (107.32 ± 30.23 pg/mlvs.145.25 ± 23.28 pg/ml,t=-6.235) in the observation group were significantly lower than those in the control group (P<0.05); the urinary protein (0.59 ± 0.25 g/24 hvs. 1.23 ± 0.36 g/24 h,t=5.263) than the control group (P<0.05), serum albumin (41.25 ± 3.69 g/Lvs.33.25 ± 3.36 g/L,t=9.582) and total protein (64.25 ± 2.36 g/Lvs.51.23 ± 2.21 g/L,t=11.365) in the observation group were significantly higher than those in the control group (P<0.05). ConclusionsTheYishen-Guyuan decoction combine with prednisone could were better than the western medcine used alone when treating nephrotic syndrom. And the combination also reduce inflammatory factors,improve renal function, and reduce urinary protein.