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[摘要]
目的 探討百令膠囊聯(lián)合他克莫司治療狼瘡性腎炎的臨床療效。方法 選取鄭州大學(xué)第一附屬醫(yī)院2014年9月—2016年2月收治的狼瘡性腎炎患者118例,隨機(jī)分為對照組和治療組,每組各59例。對照組患者空腹口服他克莫司膠囊,初始劑量為0.1 mg/(kg·d),2次/d,治療3 d后維持血藥濃度5~15 μg/L。治療組在對照組的基礎(chǔ)上口服百令膠囊,1 g/次,3次/d。兩組患者均持續(xù)治療12個(gè)月。比較兩組患者治療前后臨床療效、SLEDAI評分、血尿指標(biāo)和不良反應(yīng)情況。結(jié)果 治療后,對照組和治療組總有效率分別為69.49%、88.14%,兩組比較差異具有統(tǒng)計(jì)學(xué)意義(P< 0.05)。治療6、12個(gè)月,兩組系統(tǒng)性狼瘡性疾病活動(dòng)度(SLEDAI)評分均較同組治療前明顯降低(P< 0.05);且治療6、12個(gè)月治療組患者SLEDAI評分明顯低于同期對照組(P< 0.05)。治療6、12個(gè)月,兩組患者白蛋白(ALB)和補(bǔ)體C3均較治療前明顯升高(P< 0.05),血肌酐(Scr)、24 h尿蛋白定量(TP/24 h)和尿紅細(xì)胞(RBC)水平比治療前顯著降低(P< 0.05);與治療6個(gè)月相比,治療12個(gè)月兩組患者ALB、C3、Scr、TP/24 h和RBC水平均明顯改善(P< 0.05);且治療6、12個(gè)月治療組患者ALB、TP/24 h和RBC水平明顯優(yōu)于同期對照組(P< 0.05);治療12個(gè)月后治療組患者血C3水平顯著高于同期對照組(P< 0.05)。治療期間對照組不良反應(yīng)發(fā)生率為47.46%,顯著高于治療組的27.12%,兩組不良反應(yīng)比較差異具有統(tǒng)計(jì)學(xué)意義(P< 0.05)。結(jié)論 百令膠囊聯(lián)合他克莫司能有效提高狼瘡性腎炎的臨床治療效果,具有一定的臨床推廣應(yīng)用價(jià)值。
[Key word]
[Abstract]
Objective To explore the clinical curative effect of Bailing Capsules combined with tacrolimus in treatment of lupus nephritis. Methods Patients (118 cases) with lupus nephritis in the First Affiliated Hospital of Zhengzhou University from November 2014 to February 2016 were randomly divided into control and treatment groups, and each group had 59 cases. Patients in the control group were fasting po administered with Tacrolimus Capsules, the initial dosage was 0.1 mg/(kg·d), twice daily, the blood concentration was maintained at 5-15 μg/L after treatment for 3 d. Patients in the treatment group were po administered with Bailing Capsules on the basis of the control group, 1 g/time, three times daily. Patients in two groups were treated for 12 months. After treatment, clinical efficacy, SLEDAI scores, hematuria index, and adverse reaction in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the control and treatment groups were 69.49% and 88.14%, respectively, and there was difference between two groups (P < 0.05). After treatment for 6 and 12 months, the SLEDAI scores in two groups significantly decreased (P < 0.05). And the SLEDAI scores in treatment group were significantly lower than those in the same period in the control group (P < 0.05). After treatment for 6 and 12 months, the ALB and C3 in two groups were significantly increased (P < 0.05), while Scr, TP/24 h and RBC levels were significantly decreased (P < 0.05). Compared with those after treatment for 6 months, ALB, C3, Scr, TP/24 h and RBC levels in two groups were significantly improved after treatment for 12 months (P < 0.05). And after treatment for 6 and 12 months, ALB, TP/24 h and RBC levels in the treatment group were significantly better than those in the same period in the control group (P < 0.05). After treatment for 12 months, C3 levels in the treatment group were significantly higher than those in the same period in the control group (P < 0.05). After treatment, the adverse reaction rate in the control group was 47.46%, which were significantly higher than 27.12% in the treatment group, and there were differences between two groups (P < 0.05). Conclusion Bailing Capsules combined with tacrolimus can effectively improve the clinical therapeutic effect in treatment of lupus nephritis, which has a certain clinical application value.
[中圖分類號(hào)]
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