六味地黄丸对激素及环磷酰胺治疗狼疮性肾炎的干预作用

作者	单位
郑为超	安徽理工大学医学院
胡顺金	安徽中医学院第一附属医院肾内科
方琦	山东省济南市第三人民医院
张桃艳	安徽中医学院第一附属医院肾内科
张莉	安徽中医学院第一附属医院肾内科
任克军	山东省济南市第三人民医院

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中文摘要:

目的观察六味地黄丸对激素和环磷酰胺(CTX)治疗狼疮性肾炎(LN)的干预作用。方法64例患者随机分为两组,两组均常规采用激素标准疗程给予泼尼松,同时给予CTX8～12mg/kg加入5%葡萄糖注射液500ml静脉滴注(累积总剂量≤150mg/kg),并予对症处理;治疗组同时加服六味地黄丸。结果治疗组疗效显著优于对照组(P<0.05);24h尿蛋白定量、血浆白蛋白、血肌酐、血沉、补体C3等指标两组治疗后均显著改善(P<0.01),除血肌酐外,其他指标治疗组均优于对照组(P<0.05或P<0.01);复发率治疗组低于对照组(P<0.05);不良反应发生率治疗组显著低于对照组(P<0.01)。结论六味地黄丸能显著提高激素及CTX对LN的疗效,减少其复发,并能对抗激素及CTX的不良反应。

英文摘要:

ObjectiveTo investigate the intervening effect of Liuwei Dihuang pill （LWDH） on lupus nephropathy（LN） treated with glucocorticoids and cyclophosphamide （CTX）. MethodsSixty-four patients were randomly divided into two groups, all patients were treated by conventional treatment, using prednisone in standard program, and CTX in a daily dose of 8-12 mg/kg, accumulated dose ≤ 150 mg/kg, by adding into 500 ml of 5% glucose in saline through intravenous dripping, as well as the symptomatic treatment. Patients in the treated group were given LWDH additionally. ResultsThe curative effect in the treated group was significantly superior to that in the control group （P<0.05）.Laboratory indexes, including urinary protein, plasma protein and serum creatinine （SCr）, erythrocyte sedimentation rate （ESR）, complement C₃, etc. were significantly improved in both groups （P<0.01）, but all the improvement, except that of SCr, in the treated group were superior to those in the control group respectively （P<0.05 or P<0.01）. Besides, the recurrent rate and incidence rate of adverse reaction in the treated group was significant lower than those in the control group （P<0.05 and P<0.01）. ConclusionLWDH can significantly enhance the therapeutic effect of CTX and glucocorticoids on LN, decrease the recurrence and shows advantage in counteracting against the adverse effects of glucocorticoids and CTX.

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