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黄葵胶囊联合环磷酰胺及泼尼松治疗肾功能不全IgA肾病的临床观察
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| 篇名： | 黄葵胶囊联合环磷酰胺及泼尼松治疗肾功能不全IgA肾病的临床观察 |
| TITLE： | Clinical observation of Huangkui capsule combined with cyclophosphamide and prednisone in the treatment of IgA nephropathy with renal insufficiency |
| 摘要： | 目的 探讨黄葵胶囊联合环磷酰胺及泼尼松治疗肾功能不全免疫球蛋白A（IgA）肾病的临床疗效及安全性。方法将2021年2月－2024年3月在大连医科大学附属第二医院肾内科住院治疗的117例肾功能不全IgA肾病患者按照随机数字表法分为泼尼松组（n＝38）、环磷酰胺组（n＝39）和黄葵组（n＝40）。3组患者在标准化基础治疗上，分别予以泼尼松、泼尼松+环磷酰胺、泼尼松+环磷酰胺+黄葵胶囊治疗，疗程均为6个月。比较3组患者的临床疗效和治疗前后肾功能指标、免疫球蛋白、炎症因子水平以及治疗期间不良反应发生情况。结果最终有107例患者（泼尼松组35例、环磷酰胺组37例、黄葵组35例）完成研究。治疗6个月后，3组患者的总有效率差异有统计学意义（P＝0.028），其中黄葵组的总有效率显著高于泼尼松组（P＝0.023）。在肾功能方面，3组患者治疗后的血尿素氮（BUN）、血肌酐（Scr）、尿微量白蛋白（Umalb）水平均较治疗前显著降低，估算肾小球滤过率（eGFR）均较治疗前显著升高（P＜0.05），其中黄葵组在降低BUN水平上优于其他两组（P＜0.05），而黄葵组与环磷酰胺组在改善Scr、Umalb、eGFR上均优于泼尼松组（P＜0.05）。免疫学方面，黄葵组与环磷酰胺组在升高IgG、降低IgA及IgM水平上均优于泼尼松组（P＜0.05）。炎症因子方面，黄葵组在降低肿瘤坏死因子α水平上优于泼尼松组与环磷酰胺组（P＜0.05），在降低白细胞介素6水平上优于泼尼松组（P＜0.05）。3组患者不良反应总发生率的差异无统计学意义（P＞0.05）。结论黄葵胶囊联合环磷酰胺及泼尼松治疗肾功能不全IgA肾病的疗效较好，可进一步改善患者肾功能和免疫功能、调控炎症状态，且安全性良好。 |
| ABSTRACT： | OBJECTIVE To explore the clinical efficacy and safety of Huangkui capsule combined with cyclophosphamide and prednisone in the treatment of immunoglobulin A （IgA） nephropathy with renal insufficiency. METHODS A total of 117 patients with IgA nephropathy and renal insufficiency who were hospitalized in the department of nephrology of the Second Affiliated Hospital of Dalian Medical University from February 2021 to March 2024 were divided into prednisone group （n＝38）， cyclophosphamide group （n＝39） and Huangkui group （n＝40） according to the random number table method. On the basis of standardized basic treatment， the three groups were treated with prednisone， prednisone + cyclophosphamide， and prednisone + cyclophosphamide + Huangkui capsule， respectively， with a course of 6 months. The clinical efficacy， renal function indexes， immunoglobulin levels， inflammatory factor levels before and after treatment， and the incidence of adverse reactions during treatment were compared among the three groups. RESULTS Finally， 107 patients completed the study （35 in prednisone group， 37 in cyclophosphamide group， and 35 in Huangkui group）. After 6 months of treatment， there was a statistically significant difference in the total effective rate among the three groups （P＝0.028）， and the total effective rate of the Huangkui group was significantly higher than that of the prednisone group （P＝0.023）. In terms of renal function， the levels of blood urea nitrogen （BUN）， serum creatinine （Scr）， and urinary microalbumin （Umalb） in the three groups after treatment were significantly lower than those before treatment， while the estimated glomerular filtration rate （eGFR） was significantly higher than that before treatment （P＜0.05）. Among them， the Huangkui group was superior to the other two groups in reducing BUN level （P＜0.05）， and both the Huangkui group and cyclophosphamide group were superior to the prednisone group in improving Scr， Umalb and eGFR （P＜0.05）. In terms of immunology， both the Huangkui group and cyclophosphamide group were superior to the prednisone group in increasing IgG level and decreasing IgA and IgM levels （P＜0.05）. In terms of inflammatory factors， E-mail：amychina0411@163.com the Huangkui group was superior to the prednisone group and cyclophosphamide group in reducing tumor necrosis factor-α level （P＜0.05）， and superior to the prednisone group in reducing interleukin-6 level （P＜0.05）. There was no statistically significant difference in the total incidence of adverse reactions among the three groups （P＞0.05）. CONCLUSIONS Huangkui capsule combined with cyclophosphamide and prednisone has a good therapeutic effect on IgA nephropathy with renal insufficiency. It can further improve patients’ renal function and immune function， regulate inflammatory status， and has good safety. |
| 期刊： | 2025年第36卷第15期 |
| 作者： | 姜衍；张明；刘国鑫；赵辰阳 |
| AUTHORS： | JIANG Yan，ZHANG Ming，LIU Guoxin，ZHAO Chenyang |
| 关键字： | 黄葵胶囊；肾功能不全；IgA肾病；环磷酰胺；泼尼松；疗效；安全性；肾功能；免疫功能；炎症因子 |
| KEYWORDS： | Huangkui capsules； renal insufficiency； IgA nephropathy； cyclophosphamide； prednisone； therapeutic effect； |
| 阅读数： | 7 次 |
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