肾乐胶囊治疗系膜增殖性肾炎临床疗效观察

作者	单位
危成筠	北京中医药大学附属中西医结合医院肾内科
陈香美	解放军总医院暨解放军肾病重点实验室
张燕萍	解放军总医院暨解放军肾病重点实验室

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中文摘要:

目的 :观察肾乐胶囊 (以下简称肾乐 )对系膜增殖性肾炎的疗效 ,探讨其作用机理和临床适应症。方法 :采用病例对照研究 ,以血管紧张素转化酶抑制剂 (苯那普利 )为对照 ,将 14 2例患者随机分为肾乐组 (36例 )、肾乐加苯那普利组 (6 8例 )及苯那普利组 (38例 )。观察血纤维蛋白原 (FIB)、血脂、肾功能及尿蛋白定量等指标变化。结果 :肾乐组总有效率虽较苯那普利组高 ,但差异无显著性 ;肾乐加苯那普利组治疗 3个疗程后的疗效 (89 74 % )不仅优于苯那普利组 ,而且优于肾乐组 (均P <0 0 5 )。肾乐组与肾乐加苯那普利组胆固醇 (CH)、甘油三酯 (TG)、血肌酐 (SCr)、FIB、尿蛋白水平显著降低 (P <0 0 5或P <0 0 1) ,其中CH、TG、尿蛋白水平显著低于苯那普利组 (P <0 0 5 ) ;苯那普利组CH、TG、FIB无明显变化。结论 :中药肾乐胶囊对系膜增殖性肾炎患者具有疗效好、副作用少的特点 ,疗效与肾脏病理学改变程度有关 ,病变轻者疗效优于病变重者。肾乐联合血管紧张素转化酶抑制剂应用可取得更好的疗效。

英文摘要:

Objective: To study the therapeutic effect of Shenle capsule (SLC) in treating mesangial proliferating glomerulonephritis (MsPGN) and to explore its therapeutic mechanism and clinical indication. Methods: Adopting case control method, taking angiotensin converting enzyme inhibitor (benazepril) as control agent, the 142 cases of MsPGN were randomly divided into 3 groups, treated with SLC (Group A, n=36),SLC plus benazepril (Group B, n=68) and benazepril alone (Group C, n=38) respectively. Changes of fibrinogen, lipids, renal function and urinary protein were observed. Results: The total effective rate in Group A was higher than that in Group C, but with insignificant difference. The total effective rate in Group B after 3 courses of treatment was 89.74%, which was higher than that in Group C and Group A (P<0 05). Levels of cholesterol (CH), triglyceride (TG), serum creatinine, fibrinogen and urinary protein (UP) were significantly lowered in Group A after treatment, with the levels of CH, TG and UP lower than those in Group C, while CH, TG and fibrinogen were unchanged in Group C after treatment. Conclusion: SLC is superior in higher efficacy and less side effects in treating MsPGN, its effect is related with the degree of kidney pathological changes, it is more effective in treating patients with mild pathological change than in those with severe change. The outcome of combined use of SLC and angiotensin converting enzyme inhibitor would be better.

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