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目的:探讨中西医结合治疗原发性肾病综合征合并急性肾损伤的临床疗效。方法:选择2013年1月—2015年10月我院肾内科收治的38例成人原发性肾病综合征(PNS)合并急性肾损伤(AKI)的患者,随机选择同期诊治的30例未合并AKI的PNS患者纳入对照组,比较两组患者临床资料的差异;同时将38例PNS合并AKI的患者随机分为治疗组及常规组,每组19例,常规组患者予糖皮质激素、抗凝等对症支持治疗,治疗组在此基础上联合应用中药口服及灌肠治疗,比较两组患者治疗前后肾功能等指标的变化。结果:合并AKI的PNS患者尿蛋白定量高于对照组,感染的比例也高于对照组,差异均有统计学意义(P<0.05);两组患者比较,年龄、性别、重度浮肿比例、血白蛋白水平差异无统计学意义(P>0.05);治疗组患者治疗后血肌酐、尿素氮水平分别为(167.53±42.45)μmol/L、(11.53±2.76)mmol/L,常规组治疗后血肌酐、尿素氮水平分别为(198.18±39.63)μmol/L、(14.63±3.15)mmol/L,均较治疗前明显下降,但治疗组明显低于常规组,两组患者血白蛋白均明显上升,且治疗组高于常规组,差异均有统计学差异(P<0.05)。结论:原发性肾病综合征患者急性肾损伤的发生与大量蛋白尿及感染有关,对于这部分患者采用中西医结合治疗可提高临床疗效、保护肾功能的作用,因而值得临床进一步推广应用。
Objective: To explore the clinical efficacy of integrated traditional Chinese and western medicine in the treatment of primary nephrotic syndrome with acute renal injury. Methods: From January 2013 to October 2015, 38 patients with acute nephropathy (AKI) and 38 patients with primary nephrotic syndrome (PNS) admitted to our department of nephrology were enrolled. Thirty patients without AKI Of PNS patients were included in the control group, and the differences of clinical data between the two groups were compared. At the same time, 38 patients with PNS and AKI were randomly divided into treatment group and conventional group, with 19 cases in each group. Glucocorticoid and anticoagulation Symptomatic supportive treatment, the treatment group based on the combination of Chinese medicine oral and enema treatment, the two groups of patients before and after treatment of renal function and other indicators of change. Results: The urinary protein in PNS patients with AKI was higher than that in control group, and the infection rate was also higher than that in control group (P <0.05). The age, gender, severe edema, blood The levels of serum creatinine and urea nitrogen were (167.53 ± 42.45) μmol / L and (11.53 ± 2.76) mmol / L respectively after treatment in the treatment group, and the level of albumin in the treatment group was significantly lower than that in the control group Creatinine and urea nitrogen were (198.18 ± 39.63) μmol / L and (14.63 ± 3.15) mmol / L, respectively, which were significantly lower than those before treatment, but the treatment group was significantly lower than the conventional group, serum albumin in both groups were significantly increased , And the treatment group than the conventional group, the difference was statistically significant (P <0.05). Conclusion: The incidence of acute renal injury in patients with primary nephrotic syndrome is associated with a large number of proteinuria and infection. For this part of patients, the combination of TCM and Western medicine can improve the clinical curative effect and the protection of renal function, which deserves further clinical application.