目的 探討金水寶膠囊聯(lián)合潑尼松治療狼瘡性腎炎的臨床效果。方法 選取2018年6月-2020年12月河南科技大學第一附屬醫(yī)院收治的80例狼瘡性腎炎患者,使用隨機數(shù)字表法分成對照組和治療組,每組各40例。對照組患者口服醋酸潑尼松片,1 mg/(kg∙d),4~6周后逐步減量至最小維持量(<7.5mg/d)。在對照組基礎上,治療組口服金水寶膠囊,1.98 g/次,3次/d。兩組連續(xù)治療6個月。觀察兩組患者臨床療效,比較治療前后兩組患者腎功能指標24h尿蛋白定量(24h-Upro)、血清尿素氮(BUN)和肌酐(Cr)水平,系統(tǒng)性紅斑狼瘡疾病活動指數(shù)(SLEDAI)評分和36項健康調查簡表(SF-36)總分,中性粒細胞與淋巴細胞比值(NLR),及血清高遷移率族蛋白B1(HMGB1)、白細胞介素-18(IL-18)和細胞間黏附分子-1(ICAM-1)水平。結果 治療后,治療組總有效率為92.5%,較對照組的75.0%顯著提高(P<0.05)。治療后,兩組24 h-Upro和血清BUN、Cr水平均顯著低于治療前(P<0.05),且治療組腎功能改善作用較對照組更明顯(P<0.05)。治療后,兩組SLEDAI評分均顯著降低,而SF-36總分則均顯著升高(P<0.05),且治療組SLEDAI和SF-36評分顯著好于對照組(P<0.05)。治療后,兩組NLR和血清HMGB1、IL-18、ICAM-1水平顯著低于治療前(P<0.05),且治療組明顯低于對照組(P<0.05)。治療期間,治療組不良反應發(fā)生率明顯低于對照組(12.5% vs 32.5%,P<0.05)。結論 金水寶膠囊聯(lián)合潑尼松治療狼瘡性腎炎的整體療效確切,是保護患者腎功能、降低疾病活動度及改善生活質量的安全有效途徑。

Objective To investigate the clinical effect of Jinshuibao Capsules combined with prednisone in treatment of lupus nephritis. Methods Patients (80 cases) with lupus nephritis in the First Affiliated Hospital of Henan University of Science and Technology from June 2018 to December 2020 were randomly divided into control and treatment group, and each group had 40 cases. Patients in the control group were po administered with Prednisone Acetate Tablets, 1 mg/(kg∙d), and gradually reduced the amount to the minimum maintenance dose (< 7.5 mg/d) after 4 to 6 weeks. Patients in the treatment group were po administered with Jinshuibao Capsules on the basis of the control group, 1.98 g/time, three times daily. Patients in two groups were treated for 6 months. After treatment, the clinical evaluation was evaluated, the renal function indexes 24 h-Upro, serum BUN and Cr levels, and the scores SLEDAI and SF-36, NLR, and the levels of serum HMGB1, IL-18, and ICAM-1 in two groups before and after treatment were compared. Results After treatment, the clinical effective rate of the treatment group was 92.5%, which was significantly higher than 75.0% of the control group (P < 0.05). After treatment, the levels of 24 h-upro and serum BUN and Cr in two groups were significantly lower than those before treatment (P < 0.05), and the improvement of renal function in the treatment group was more obvious than that in the control group (P < 0.05). After treatment, the SLEDAI score in two groups were significantly decreased, while the total score of SF-36 were significantly increased (P < 0.05), and the scores of SLEDAI and SF-36 in the treatment group were significantly better than those in the control group (P < 0.05). After treatment, the concentrations of NLR, serum HMGB1, IL-18, and ICAM-1 levels in two groups were significantly lower than those before treatment (P < 0.05), and which in the treatment group were significantly lower than those in the control group (P < 0.05). During the treatment period, the adverse reaction rate in the treatment group was significantly lower than that in the control group (12.5% vs 32.5%, P < 0.05). Conclusion Jinshuibao Capsules combined with prednisone in treatment of lupus nephritis is a safe and effective way to protect patients' renal function, reduce disease activity and improve quality of life.

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