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目的:观察乙肝肾合剂辨证加减联合常规西药综合治疗乙型肝炎病毒相关性肾炎(HBV-GN)临床疗效。方法:纳入48例我院门诊和住院部HBV-GN患者,依据治疗方式不同,随机分为对照组和治疗组(各24例),均给予常规西药治疗,治疗组加用乙肝肾合剂辨证加减综合治疗,比较两组治疗前后临床症状改善、肝、肾功能指标、HBV血清标记物变化和治疗效果。结果:治疗后,肝、肾功能异常、蛋白尿、血尿和下肢水肿患者均显著显著减少,且治疗组减少例数多于对照组,差异显著(P<0.05);治疗后两组TBIL、DBIL、ALT、PT水平显著下降,白蛋白水平显著上升,24 h尿蛋白、Scr和BUN水平均显著降低,Ccr水平显著升高,且治疗组降低或升高水平显著高于对照组,差异显著(P<0.05);治疗组HBeAg阴转率40%,HBs Ag阴转率25%,对照组分别为28.57%和20.83%,两组差异不显著(P>0.05);治疗后治疗组HBV-DNA拷贝量下降水平显著高于对照组(P<0.05);治疗组治疗总有效率91.67%,对照组66.67%,两组差异显著(P<0.05)。结论:乙肝肾合剂辨证加减联合常规西药治疗可显著改善乙型肝炎病毒相关性肾炎临床症状,改善患者肝、肾功能,疗效显著,值得临床推广应用。
Objective: To observe the clinical efficacy of combined treatment of hepatitis B and kidney with syndrome differentiation and traditional Chinese medicine in the treatment of hepatitis B virus associated nephritis (HBV-GN). Methods: 48 cases of HBV-GN patients from outpatient department and inpatient department of our hospital were enrolled. According to different treatment methods, they were randomly divided into control group and treatment group (24 cases each). All patients were given conventional western medicine. Less comprehensive treatment, the two groups before and after treatment to improve the clinical symptoms, liver and kidney function, HBV serum markers and treatment effect. Results: After treatment, the liver and renal dysfunction, proteinuria, hematuria and lower extremity edema were significantly reduced, and the treatment group decreased more than the control group, the difference was significant (P <0.05); after treatment, the two groups TBIL, DBIL , ALT, PT levels decreased significantly, albumin levels increased significantly, 24 h urinary protein, Scr and BUN levels were significantly lower, Ccr levels were significantly increased, and the treatment group decreased or increased significantly higher than the control group, the difference was significant P <0.05). In the treatment group, the negative conversion rate of HBeAg was 40%, the negative conversion rate of HBsAg was 25%, while the control group was 28.57% and 20.83% respectively. There was no significant difference between the two groups (P> 0.05) (P <0.05). The total effective rate was 91.67% in the treatment group and 66.67% in the control group, with significant difference between the two groups (P <0.05). Conclusion: The syndrome differentiation of hepatitis B and kidney combined with conventional western medicine can significantly improve the clinical symptoms of hepatitis B virus-associated nephritis and improve the liver and renal function in patients with significant curative effect, which is worthy of clinical application.