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肾9方联合清热摩肾颗粒治疗多种西药治疗无效的特发性膜性肾病的临床观察

[Clinical observation of Shen No. 9 Recipe with Qingre Moshen Granule on the treatment of idiopathic membranous nephropathy after treated by multiple Western drugs with no efficacy].

作者信息

Han Li, Deng Yue-yi, Chen Yi-ping

机构信息

Department of Nephrology, Lianyungang Hospital of Traditional Chinese Medicine, Jiangsu (222004).

出版信息

Zhongguo Zhong Xi Yi Jie He Za Zhi. 2011 Nov;31(11):1496-501.

Abstract

OBJECTIVE

To observe the clinical efficacy of Shen No. 9 Recipe (SR) combined with Qingre Moshen Granule (QMG) in treatment of idiopathic membranous nephropathy (IMN) patients with no efficacy after treated by hormone or immunosuppressive agent, and further to explore the possible mechanism of this method in treatment of IMN by detecting the cellular immune function and cytokine interleukin-2 (IL-2).

METHODS

Forty-four IMN patients with no efficacy after treated by multiple Western drugs were recruited from October 2007 to October 2009. They took SR (one dosage daily, oral administration in two portions) and QMG (each package each time, thrice daily) for 24 weeks. The 24-h urine protein, glomerular filtration rate (GFR), plasma albumin (Alb), serum creatinine (SCr), urea nitrogen (BUN), triglyceride (TG), serum total cholesterol (TC), levels of cellular immune function (CD4+, CD8+, CD4+/CD8+ ratio), and IL-2 were detected before and after treatment. The changes of Chinese medicine syndrome and adverse reactions were observed and recorded.

RESULTS

After treatment the complete remission rate, the basic remission rate, and the total effective rate was 4.5%, 68.2%, 84.1%, respectively. The total markedly-effective rate of Chinese medicine syndrome was 90.9%. The Chinese medicine syndrome was significantly lower than before treatment (P < 0.01). The 24-h urine protein obviously decreased (P < 0.01), Alb obviously increased (P < 0.01), levels of TC and TG obviously decreased (P < 0.01, P < 0.05). There was no obvious change in levels of SCr and BUN (P > 0.05). The GFR significantly increased (P < 0.05). CD4+ and the ratio of CD4+/CD8+ were obviously elevated (P < 0.01) and the CD8+ obviously decreased (P < 0.01). The expression level of IL-2 obviously increased, but it still was lower than the normal value, showing statistical difference (P < 0.01).

CONCLUSIONS

SR + QMG showed definite efficacy in treatment of IMN patients with no efficacy after treated by multiple Western drugs. It could improve the level of cellular immunity and improve abnormal expression levels of IL-2.

摘要

目的

观察肾9方联合清热莫肾颗粒治疗经激素或免疫抑制剂治疗无效的特发性膜性肾病(IMN)患者的临床疗效,并通过检测细胞免疫功能及细胞因子白细胞介素-2(IL-2),进一步探讨该方法治疗IMN的可能机制。

方法

选取2007年10月至2009年10月期间经多种西药治疗无效的44例IMN患者。给予肾9方(每日1剂,分2次口服)和清热莫肾颗粒(每次1包,每日3次),疗程24周。检测治疗前后24小时尿蛋白、肾小球滤过率(GFR)、血浆白蛋白(Alb)、血清肌酐(SCr)、尿素氮(BUN)、甘油三酯(TG)、血清总胆固醇(TC)、细胞免疫功能水平(CD4+、CD8+、CD4+/CD8+比值)及IL-2。观察并记录中医证候变化及不良反应。

结果

治疗后完全缓解率、基本缓解率、总有效率分别为4.5%、68.2%和84.1%。中医证候总显效率为90.9%。中医证候较治疗前明显改善(P<0.01)。24小时尿蛋白明显降低(P<0.01),Alb明显升高(P<0.01),TC和TG水平明显降低(P<0.01,P<0.05)。SCr和BUN水平无明显变化(P>0.05)。GFR显著升高(P<0.05)。CD4+及CD4+/CD8+比值明显升高(P<0.01),CD8+明显降低(P<0.01)。IL-2表达水平明显升高,但仍低于正常值,差异有统计学意义(P<0.01)。

结论

肾9方联合清热莫肾颗粒治疗经多种西药治疗无效的IMN患者疗效确切。可提高细胞免疫水平,改善IL-2异常表达水平。

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