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目的:观察中药辅助激素联合环磷酰胺治疗狼疮性肾炎(LN)的临床疗效。方法:选择临床确诊的LN 128例,随机分为观察组68例及对照组60例;对照组给予常规激素联合环磷酰胺冲击治疗,观察组在对照组治疗基础上辅以自拟中药方剂治疗。分别检测治疗前及治疗后6个月、12个月系统性红斑狼疮活动度评分(SLEDAI)、激素用量、24h尿蛋白定量、血清肌酐和尿素氮、血清清蛋白水平,对比分析两组临床疗效。结果:(1)观察组治疗后6个月、12个月的24h尿蛋白定量、血清尿素氮及肌酐水平均显著低于对照组(P<0.05),血清清蛋白水平显著高于对照组(P<0.05)。(2)观察组治疗后6个月、12个月激素用量分别为(18.6±7.2)mg/d和(10.3±3.6)mg/d,均显著低于对照组的(24.3±8.2)mg/d和(16.3±5.2)mg/d(P<0.05)。(3)观察组治疗后12个月完全缓解52例(76.5%)、部分缓解14例(20.6%)、治疗失败2例(2.9%),总缓解率97.1%;对照组治疗后12个月完全缓解32例(53.3%)、部分缓解18例(30.0%)、治疗失败10例(16.7%),总缓解率83.3%。观察组总缓解率显著高于对照组(P<0.05)。结论:中药辅助激素联合环磷酰胺治疗LN,有助于提高临床疗效,并能减少激素用量。
Objective: To observe the clinical efficacy of Chinese medicine combined with cyclophosphamide in the treatment of lupus nephritis (LN). Methods: 128 cases of clinically diagnosed LN were randomly divided into observation group (n = 68) and control group (n = 60). The control group was treated with conventional hormones combined with cyclophosphamide. The observation group was treated with self-made traditional Chinese medicine . The levels of systemic lupus erythematosus (SLEDAI), hormones, 24h urinary protein, serum creatinine, urea nitrogen and serum albumin were measured before and 6 months and 12 months after treatment respectively. The clinical efficacy was compared between the two groups . Results: (1) The urinary protein excretion, serum urea nitrogen and creatinine in observation group at 6 and 12 months after treatment were significantly lower than those in control group (P <0.05), serum albumin level was significantly higher than that in control group P <0.05). (2) The dosage of hormones in observation group was (18.6 ± 7.2) mg / d and (10.3 ± 3.6) mg / d at 6 months and 12 months respectively, which were significantly lower than those in control group (24.3 ± 8.2) mg / d and (16.3 ± 5.2) mg / d, respectively (P <0.05). (3) In the observation group, complete remission was achieved in 52 cases (76.5%) at 12 months and partial remission in 14 cases (20.6%). The failure rate was 2 cases (2.9%) in the observation group and the total remission rate was 97.1% 32 cases (53.3%) were relieved completely, 18 cases (30.0%) partially relieved, 10 cases (16.7%) failed treatment, and the total remission rate was 83.3%. The total remission rate in observation group was significantly higher than that in control group (P <0.05). Conclusion: Chinese medicine adjuvant hormone combined with cyclophosphamide in the treatment of LN, help to improve the clinical efficacy, and can reduce the amount of hormones.