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目的观察中西医结合方法改善狼疮性肾炎患者激素治疗的撤减及不良反应的效果。方法回顾性分析2011年1月至2012年12月收治的以肾上腺糖皮质激素(泼尼松)及免疫抑制剂(环磷酰胺)治疗的狼疮性肾炎113例患者的临床资料,其中采用上述西药治疗者57例(西药组),采用中西药联合治疗(加自制中医验方滋肾膏)者56例(中西药联合组),比较在6个月疗程中,两组的激素撤减情况及不良反应发生情况。结果 6个月疗程中,中西药联合组患者平均每日泼尼松用量明显低于西药组[(15.4±3.5)mg/d vs(22.5±5.2)mg/d,P<0.05]。治疗后与西药组比较,中西药联合组患者空腹血糖、胆固醇、低密度脂蛋白胆固醇水平均降低(P均<0.05);不良反应:感染发生率(8.9%vs 24.6%)、肝功能异常率(5.4%vs19.3%)、胃肠道反应发生率(8.9%vs 26.3%)均下降,差异均有统计学意义(P均<0.05)。结论加滋肾膏中西药联合应用能降低患者治疗过程中泼尼松的平均使用量,促进激素撤减,降低感染、肝功能异常及胃肠道反应的发生率,减少泼尼松治疗对血糖及血脂的不良影响。
Objective To observe the combination of Chinese and Western medicine to improve lupus nephritis in patients with withdrawal and adverse effects of hormone therapy. Methods The clinical data of 113 patients with lupus nephritis treated with glucocorticoid (prednisone) and immunosuppressive agents (cyclophosphamide) from January 2011 to December 2012 were retrospectively analyzed. Among them, the above western medicine Fifty-seven patients (Western medicine group) received traditional Chinese medicine and western medicine combined with traditional Chinese medicine prescription Fangzizhixao (56 cases) (Chinese-Western medicine combined group). The treatment of six months’ Reaction occurred. Results The average daily prednisone dosage in the combined Chinese and Western medicine groups was significantly lower than that in the Western medicine group [(15.4 ± 3.5) mg / d vs (22.5 ± 5.2) mg / d for 6 months. Compared with Western medicine group, the fasting blood glucose, cholesterol and low density lipoprotein cholesterol levels were lower in the combination group (all P <0.05). The adverse reactions were infection rate (8.9% vs 24.6%), abnormal liver function rate (5.4% vs19.3%) and the incidence of gastrointestinal reactions (8.9% vs26.3%), all of which were statistically significant (all P <0.05). Conclusion The combination of ZZT with traditional Chinese and western medicine can reduce the average dosage of prednisone during the course of treatment, promote the withdrawal of hormone, reduce the incidence of infection, abnormal liver function and gastrointestinal reaction, and reduce the effect of prednisone on blood sugar And the adverse effects of blood lipids.