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目的分析醋酸泼尼松和环磷酰胺冲击疗法联合雷公藤多苷治疗肾病综合征的疗效及其安全性。方法选取2015年2月至2016年2月就诊的肾病综合征患者72例作为研究对象,随机分为两组,对照组(36例)给予醋酸泼尼松和环磷酰胺冲击疗法治疗,治疗组(36例)在醋酸泼尼松和环磷酰胺冲击疗法治疗基础上联合雷公藤多苷治疗,对比两组治疗前后血常规、肝功能、血清炎症因子及24 h尿蛋白(24 h Upro)水平变化。结果 (1)两组治疗后白细胞计数(WBC)、24 h Upro水平明显下降,血清白蛋白(ALB)、血浆总蛋白(TP)水平明显升高(P均<0.01),且治疗组治疗后WBC、24 h Upro水平低于对照组,ALB、TP水平高于对照组(P均<0.01);(2)两组治疗后白介素-1(IL-1)、肿瘤坏死因子-α(TNF-α)水平均下降(P<0.05,P<0.01),且治疗组治疗后IL-1、TNF-α水平均低于对照组(P均<0.01);(3)治疗组治疗后总有效率及不良反应发生率均明显高于对照组(P<0.05,P<0.01)。结论对肾病综合征患者在醋酸泼尼松和环磷酰胺冲击疗法治疗基础上联合雷公藤多苷治疗的疗效较好,可促进患者康复,但不良反应相对较多,临床治疗期间应密切观察。
Objective To analyze the efficacy and safety of combination of prednisone acetate and cyclophosphamide in the treatment of nephrotic syndrome with tripterygium glycosides. Methods Seventy-two patients with nephrotic syndrome who were treated from February 2015 to February 2016 were randomly divided into two groups. The control group (36 cases) was given prednisolone and cyclophosphamide. The treatment group (36 cases) combined with tripterygium glycosides treatment on the basis of the impact therapy of prednisone and cyclophosphamide, comparing the blood routine, liver function, serum inflammatory cytokines and 24 h urinary protein level before and after treatment Variety. Results (1) The WBC and 24 h Upro levels of both groups were significantly decreased and the levels of serum albumin (ALB) and total protein (TP) were significantly increased after treatment (P <0.01) (P <0.01). (2) After treatment, the levels of IL-1, TNF-alpha and TNF-alpha in the two groups were significantly lower than those in the control group (P <0.05, P <0.01), and the levels of IL-1 and TNF-α in the treatment group were lower than those in the control group (all P <0.01); (3) The total effective rate And the incidence of adverse reactions were significantly higher than the control group (P <0.05, P <0.01). Conclusions The treatment of nephrotic syndrome patients with combination of tripterygium glycosides and prednisone acetate and cyclophosphamide is effective in the treatment of patients, which can promote the recovery of patients. However, there are relatively more adverse reactions and should be closely observed during the clinical treatment.