自拟首乌地黄汤配合西药治疗狼疮性肾炎肝肾阴虚证的临床观察
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摘要
目的:探讨自拟首乌地黄汤配合西药对狼疮性肾炎肝肾阴虚证的临床疗效及作用机理。
方法:将符合纳入标准的85例患者随来源分成治疗组43例和对照组42例,治疗组采用常规西药结合中药首乌地黄汤,每日1剂,分3次饭后服用。对照组予以常规西医药治疗,主要药物为激素和免疫抑制剂。分别观察两组患者临床症状、体征、实验室指标的改善情况及不良反应,观察时间为六月。
结果:(1)治疗组总有效率(86.04%)与对照组总有效率(76.19%)相比有显著性差异(P=0.03＜0.05),说明中西医结合方法疗效优于单纯西医治疗组;(2)治疗组在改善患者临床症状,降低症状积分,活动积分,明显优于对照组,二者比较有显著性差异(P＜0.05或0.01):(3)两组治疗前后实验室指标均有不同程度改善,其中治疗组改善尿蛋白、BUN、Cr等较明显,优于对照组,差异有显著性(P＜0.05);(4)在激素撤减情况方面,治疗组激素每日用量明显低于对照组(P＜0.05);(5)在西药副作用比较方面,治疗组副作用发生率明显低于对照组,差异有显著性意义(P＜0.05)。
结论:以自拟首乌地黄汤配合西药治疗狼疮性肾炎肝肾阴虚证具有较满意的临床疗效,在改善临床症状、控制LN活动、降低蛋白尿、保护肾功能、减少激素用量、减轻副作用等方面,中西医结合治疗组疗效更好,推测其可能是通过多途径作用于狼疮性肾炎的发病环节而起作用的。
Objective: To study the efficacy and pharmacological mechanism of Shouwudihuang decoction in patients with lupus nephritis caused by liver and kidney yin deficiency.
Methods: 85 with lupus nephritis caused by liver and kidney yin deficiency were divided into two groups, including treatment group and control group. The treatment group were treated with ShouWuDingHuang decoction and western medicine. The controlled group with western medicine was mainly treated with hormonal and immune-suppressive medication. The clinical symptoms、signs pre-treatment and post-treatment、laboratory examination and adverse reaction were comparatively observed. Period of observation was 6 month.
Result: (1) the total efficiency of the treatment group is 86.04%. The total efficiency of the control group is 76.19%. The total efficiency of the treatment better than the control group (P<0.05). (2) The control group has good therapeutic effect improving clinical symptom、descending active scales and so on. (3) In experiment guide line, the two group are ameliorate in some aspects, such as reducing urine protein、BUN、Cr et. (4) The needed doses of hormones were significantly lower in the control group (P<0.05). (5)The occurrence of side effects were also lower (P<0.05).
Conclusion: there is satisfied curative effect using ShouWuDiHuang decoction and western medicine to treat lupus nephritis caused by liver and kidney yin deficiency. It suggest that it maybe effective through various different pharmacological mechanisms.
方法:将符合纳入标准的85例患者随来源分成治疗组43例和对照组42例,治疗组采用常规西药结合中药首乌地黄汤,每日1剂,分3次饭后服用。对照组予以常规西医药治疗,主要药物为激素和免疫抑制剂。分别观察两组患者临床症状、体征、实验室指标的改善情况及不良反应,观察时间为六月。
结果:(1)治疗组总有效率(86.04%)与对照组总有效率(76.19%)相比有显著性差异(P=0.03＜0.05),说明中西医结合方法疗效优于单纯西医治疗组;(2)治疗组在改善患者临床症状,降低症状积分,活动积分,明显优于对照组,二者比较有显著性差异(P＜0.05或0.01):(3)两组治疗前后实验室指标均有不同程度改善,其中治疗组改善尿蛋白、BUN、Cr等较明显,优于对照组,差异有显著性(P＜0.05);(4)在激素撤减情况方面,治疗组激素每日用量明显低于对照组(P＜0.05);(5)在西药副作用比较方面,治疗组副作用发生率明显低于对照组,差异有显著性意义(P＜0.05)。
结论:以自拟首乌地黄汤配合西药治疗狼疮性肾炎肝肾阴虚证具有较满意的临床疗效,在改善临床症状、控制LN活动、降低蛋白尿、保护肾功能、减少激素用量、减轻副作用等方面,中西医结合治疗组疗效更好,推测其可能是通过多途径作用于狼疮性肾炎的发病环节而起作用的。
Objective: To study the efficacy and pharmacological mechanism of Shouwudihuang decoction in patients with lupus nephritis caused by liver and kidney yin deficiency.
Methods: 85 with lupus nephritis caused by liver and kidney yin deficiency were divided into two groups, including treatment group and control group. The treatment group were treated with ShouWuDingHuang decoction and western medicine. The controlled group with western medicine was mainly treated with hormonal and immune-suppressive medication. The clinical symptoms、signs pre-treatment and post-treatment、laboratory examination and adverse reaction were comparatively observed. Period of observation was 6 month.
Result: (1) the total efficiency of the treatment group is 86.04%. The total efficiency of the control group is 76.19%. The total efficiency of the treatment better than the control group (P<0.05). (2) The control group has good therapeutic effect improving clinical symptom、descending active scales and so on. (3) In experiment guide line, the two group are ameliorate in some aspects, such as reducing urine protein、BUN、Cr et. (4) The needed doses of hormones were significantly lower in the control group (P<0.05). (5)The occurrence of side effects were also lower (P<0.05).
Conclusion: there is satisfied curative effect using ShouWuDiHuang decoction and western medicine to treat lupus nephritis caused by liver and kidney yin deficiency. It suggest that it maybe effective through various different pharmacological mechanisms.
引文
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