目的 分析尿毒清顆粒聯合甲潑尼龍治療腎病綜合征的臨床療效。方法 選取2018年2月-2021年11月天津市第五中心醫(yī)院收治的200例腎病綜合征患者,按隨機數字表法將入選患者分為對照組和治療組,每組各100例。對照組晨起頓服甲潑尼龍片,0.8 mg/kg。治療組在對照組基礎上口服尿毒清顆粒,5 g/次,3次/d,溫開水沖服。兩組療程均為8周。觀察兩組的臨床療效,比較治療前后兩組腎功能相關指標[白蛋白(ALB)、尿素氮(BUN)],腎血流動力學參數[收縮期峰值流速(Vs)、阻力指數(RI)],血清白細胞介素(IL)-6、IL-9、補體C3、丙二醛(MDA)和轉移生長因子-β1(TGF-β1)水平。結果 治療后,治療組總有效率為91.00%,顯著高于對照組的81.00%(P<0.05)。治療后,兩組血清ALB水均顯著高于治療前,血清BUN、Cr水平和24h UP均顯著低于治療前(P<0.05);且治療組改善更顯著(P<0.05)。相比治療前,治療后兩組腎葉間動脈V_s均顯著提高,RI和PI均顯著降低(P<0.05);且治療組改善更顯著(P<0.05)。治療后,兩組血清IL-6、IL-9、MDA和TGF-β1水平均較治療前顯著下降,血清補體C3水平均較治療前顯著上升(P<0.05);且均以治療組改善更顯著(P<0.05)。結論 尿毒清顆粒聯合甲潑尼龍對腎病綜合征具有確切療效,能安全有效地改善患者腎功能及腎血流動力學,減輕機體免疫炎癥反應和氧化應激,抑制腎臟纖維化。

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.

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