目的 分析尿毒清颗粒联合甲泼尼龙治疗肾病综合征的临床疗效。方法 选取2018年2月-2021年11月天津市第五中心医院收治的200例肾病综合征患者,按随机数字表法将入选患者分为对照组和治疗组,每组各100例。对照组晨起顿服甲泼尼龙片,0.8 mg/kg。治疗组在对照组基础上口服尿毒清颗粒,5 g/次,3次/d,温开水冲服。两组疗程均为8周。观察两组的临床疗效,比较治疗前后两组肾功能相关指标[白蛋白(ALB)、尿素氮(BUN)],肾血流动力学参数[收缩期峰值流速(Vs)、阻力指数(RI)],血清白细胞介素(IL)-6、IL-9、补体C3、丙二醛(MDA)和转移生长因子-β1(TGF-β1)水平。结果 治疗后,治疗组总有效率为91.00%,显著高于对照组的81.00%(P<0.05)。治疗后,两组血清ALB水均显著高于治疗前,血清BUN、Cr水平和24h UP均显著低于治疗前(P<0.05);且治疗组改善更显著(P<0.05)。相比治疗前,治疗后两组肾叶间动脉V_s均显著提高,RI和PI均显著降低(P<0.05);且治疗组改善更显著(P<0.05)。治疗后,两组血清IL-6、IL-9、MDA和TGF-β1水平均较治疗前显著下降,血清补体C3水平均较治疗前显著上升(P<0.05);且均以治疗组改善更显著(P<0.05)。结论 尿毒清颗粒联合甲泼尼龙对肾病综合征具有确切疗效,能安全有效地改善患者肾功能及肾血流动力学,减轻机体免疫炎症反应和氧化应激,抑制肾脏纤维化。

Objective To analyze the clinical efficacy of Niaoduqing Granules combined with methylprednisolone in treatment of nephrotic syndrome. Methods A total of 200 patients with nephrotic syndrome admitted to Tianjin Fifth Central Hospital from February 2018 to November 2021 were selected and divided into control group and treatment group according to the random number table method, with 100 cases in each group. Patients in the control group were po administered with Methylprednisolone Tablets in the morning, 0.8 mg/kg. Patients in the treatment group were po administered with Niaoduqing Granules with warm boiling water on the basis of the control group, 5 g/time, three times daily. The treatment course of both groups was 8 weeks. The clinical efficacy of the two groups was observed. The renal function-related indicators such as albumin (ALB), urea nitrogen (BUN), renal hemodynamic parameters such as peak systolic flow velocity (Vs), resistance index (RI), serum Interleukin (IL)-6, IL-9, complement C3, malondialdehyde (MDA) and transfer growth factor-β1 (TGF-β1) levels in two groups before and after treatment were compared. Results After treatment, the total effective rate of the treatment group was 91.00%, which was significantly higher than that of the control group (81.00%, P＜0.05). After treatment, serum ALB water was significantly higher than before treatment, serum BUN, Cr levels and 24 h UP were significantly lower than before treatment (P＜0.05). The improvement was more significant in the treatment group (P＜0.05). After treatment, Vs was significantly increased, RI and PI were significantly decreased in the two groups (P＜0.05). The improvement was more significant in the treatment group (P＜0.05). After treatment, the serum levels of IL-6, IL-9, MDA, and TGF-β1 in the two groups were significantly decreased, and the serum complement C3 level was significantly increased compared with that before treatment (P＜0.05). The improvement was more significant in the treatment group (P＜0.05). Conclusion Niaoduqing Granules combined with methylprednisolone has definite curative effect in treatment of nephrotic syndrome, can safely and effectively improve renal function and renal hemodynamics, reduce immune inflammatory response and oxidative stress, and inhibit renal fibrosis.

R914