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[摘要]
目的 探讨黄葵胶囊联合吗替麦考酚酯治疗IgA肾病的临床效果。方法 选取2015年3月—2018年3月四川省甘孜州人民医院收治的IgA肾病患者81例,随机分成对照组(40例)和治疗组(41例)。对照组餐后2 h口服吗替麦考酚酯胶囊,3粒/次,2次/d。治疗组在对照组基础上餐后30 min口服黄葵胶囊,5粒/次,3次/d。两组均连续治疗12周。观察两组患者临床疗效,同时比较治疗前后两组患者24 h尿蛋白定量(24 h UPQ)、尿沉渣红细胞(RBC)计数、血清肌酐(Cr)、肾小球滤过率(eGFR)值、超敏C反应蛋白(hs-CRP)、白介素-6(IL-6)、免疫球蛋白A(IgA)、补体C3、IgA/C3水平。结果 治疗后,对照组和治疗组临床有效率分别为75.0%、92.7%,两组比较差异具有统计学意义(P<0.05)。治疗后,两组24 h UPQ、尿沉渣RBC计数和血清Cr水平较治疗前均显著降低(P<0.05),eGFR值显著升高(P<0.05),且治疗组这些肾功能相关指标明显优于对照组(P<0.05)。治疗后,两组血清hs-CRP、IL-6、IgA水平和IgA/C3比值均显著下降(P<0.05),血清补体C3浓度显著上升(P<0.05),且治疗组hs-CRP、IL-6、IgA、补体C3、IgA/C3水平明显优于对照组(P<0.05)。结论 黄葵胶囊联合吗替麦考酚酯治疗IgA肾病可明显改善患者肾功能,减轻炎性损伤,下调血中IgA表达水平,抑制补体系统异常激活,延缓肾脏损伤。
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[Abstract]
Objective To investigate the clinical effect of Huangkui Capsules combined with mycophenolate mofetil in treatment of IgA nephropathy. Methods Patients (81 cases) with IgA nephropathy in Ganzi Tibetan Autonomous Prefecture People's Hospital from March 2015 to March 2018 were randomly divided into control (40 cases) and treatment (41 cases) groups. Patients in the control group were po administered with Mycophenolate Mofetil Capsules, 3 grains/time, twice daily. Patients in the treatment group were po administered with Huangkui Capsules on the basis of the control group, 5 grains/time, three times daily. Patients in two groups were treated for 12 weeks. After treatment, the clinical efficacy was evaluated, and the 24 h UPQ, RBC count, serum Cr, eGFR value, hs-CRP, IL-6, Ig A, complement C3, IgA/C3 levels in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the control and treatment groups was 75.0% and 92.7% respectively, and there were differences between two groups (P<0.05). After treatment, the 24 h UPQ, RBC count of urinary sediment and serum Cr levels in two groups were significantly decreased (P<0.05), but eGFR value was significantly increased (P<0.05), and these renal function related indicators in the treatment group were significantly better than those in the control group (P<0.05). After treatment, the serum hs-CRP, IL-6, IgA and IgA/C3 in two groups were significantly decreased (P<0.05), but complement C3 concentration was significantly increased (P<0.05), and these indicators in the treatment group were significantly better than those in the control group (P<0.05). Conclusion Huangkui Capsules combined with mycophenolate mofetil in treatment of IgA nephropathy can significantly improve renal function, reduce inflammatory injury, down-regulate IgA expression, inhibit abnormal activation of complement system, delay kidney damage.
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