知柏地黄丸与五苓散联合常规疗法治疗肾病综合征临床研究
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R692;R277.5

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Clinical Study on Zhibai Dihuang Pills and Wuling Powder Combined with Routine Therapy for Nephrotic Syndrome
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    摘要:

    目的:观察在常规疗法与激素的基础上加用知柏地黄丸联合五苓散治疗肾病综合征(NS) 肝肾阴虚兼水湿内停证的疗效。方法:将纳入的68 例NS 肝肾阴虚兼水湿内停证患者随机分为对照组和观察组各34 例。2 组均予免疫支持、补充优质蛋白等常规基础疗法,并接受醋酸泼尼松片治疗,观察组加予知柏地黄丸联合五苓散治疗,2 组疗程均为6 个月。比较2 组的疗效, 记录并比较患者治疗前后的血清骨代谢指标[骨钙素(BGP)、全段甲状旁腺激素(iPTH) 和骨特异性碱性磷酸酶(BALP)]、肾功能指标[尿β2-微球蛋白(β2-MG)、α1-微球蛋白(α1-MG)]、血清炎症指标[白细胞介素(IL) -4、IL-6水平。结果:治疗6 个月,观察组的临床疗效总有效率高于对照组(P<0.01)。2 组血清BGP 水平均较治疗前升高,血清iPTH、BALP 水平均较治疗前下降,差异均有统计学意义(P<0.05)。观察组血清BGP 水平高于对照组,血清iPTH、BALP 水平均低于对照组,差异均有统计学意义(P<0.05)。2 组尿β2-MG、α1-MG 水平均较治疗前下降(P<0.05),观察组尿β2-MG、α1-MG 水平均低于对照组(P<0.05)。2 组血清IL-4、IL-6 水平均较治疗前下降(P<0.05),观察组血清IL-4、IL-6 水平均低于对照组(P<0.05)。结论:在常规疗法与服用醋酸泼尼松片的基础上加用知柏地黄丸与五苓散治疗NS 肝肾阴虚兼水湿内停证患者,相较于西药治疗,能更有效地减轻炎症,提高临床疗效,改善骨代谢和肾功能。

    Abstract:

    Abstract:Objective:To observe the curative effect of the therapy of Zhibai Dihuang pills combined with Wuling powder based on routine therapy on nephrotic syndrome(NS) of syndrome of liver- kidney yin deficiency complicated with waterdampness retention. Methods: A total of 68 patients with NS of syndrome of liver- kidney yin deficiency complicated with water- dampness retention were randomly divided into the control group and the observation group,with 34 cases in each group. Both groups were treated with routine basic therapy,such as immune support and high-quality protein supplement, and prednisone acetate tablets. The observation group was additionally treated with Zhibai Dihuang pills combined with Wuling powder. Both groups were treated for six months. The curative effects in the two groups were compared. Before and after treatment, the serum bone metabolism indexes, including bone gla protein(BGP), intact parathyroid hormone(iPTH) and bone- specific alkaline phosphatase(BALP), kidney function indexes, including urine β2- microglobulin(β2- MG) and α1- microglobulin(α1- MG), and serum inflammatory indexes, including interleukin- 4(IL- 4) and interleukin- 6(IL- 6), were compared. Results:After six months of treatment,the total clinical effective rate in the observation group was higher than that in the control group(P<0.01). The serum BGP levels in both groups were increased when compared with those before treatment,and the serum levels of iPTH and BALP were decreased,differences being significant(P<0.05). The serum BGP level in the observation group was higher than that in the control group,and the serum levels of iPTH and BALP were lower, differences being significant(P<0.05). The levels of urine β2- MG and α1- MG in the two groups were decreased when compared with those before treatment(P<0.05),and the two levels in the observation group were lower than those in the control group(P<0.05). The serum levels of IL- 4 and IL- 6 in the two groups were decreased when compared with those before treatment(P<0.05),and the above two levels in the observation group were lower than those in the control group(P< 0.05). Conclusion: Compared with western medicine treatment, the therapy of Zhibai Dihuang pills and Wuling powder based on routine therapy for patients with NS of syndrome of liver-kidney yin deficiency complicated with water-dampness rentention can more effectively reduce the inflammation,enhance the clinical effect,and improve the bone metabolism and kidney function.

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王亚梅.知柏地黄丸与五苓散联合常规疗法治疗肾病综合征临床研究[J].新中医,2022,54(6):57-61

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  • 在线发布日期: 2022-03-25
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