黄芪注射液联合拉米夫定治疗乙型肝炎相关性肾炎临床观察.docVIP

黄芪注射液联合拉米夫定治疗乙型肝炎相关性肾炎临床观察 【摘要】 目的 探讨黄芪注射液联合拉米夫定治疗乙型肝炎相关性肾炎（HBV-GN）的疗效及作用机制。方法 将55例HBV-GN患者按双盲法随机分为2组，对照组25例予拉米夫定100 mg，每日1次口服，治疗组30例在对照组的基础上加用黄芪注射液40 mL,每日1次静脉滴注。2组均24周为1个疗程。2组均在治疗前、治疗第12、24周及随访6个月后行症状积分评定各1次，并观察2组临床疗效。结果 2组治疗后各症状积分与本组治疗前比较差异均有统计学意义(P＜0.01);2组治疗后食欲及腹胀积分比较差异均有统计学意义(P＜0.01), 乏力及水肿积分比较差异无统计学意义（Pgt;0.01）。2组证候及尿蛋白疗效比较差异均有统计学意义（Plt;0.05）。其他实验室指标疗效比较差异无统计学意义（P＞0.05）。结论 黄芪注射液联合拉米夫定治疗HBV-GN在改善证候及尿蛋白方面优于单纯拉米夫定治疗。 【关键词】 肾炎；肝炎,乙型,慢性；黄芪；中西医结合疗法　　　 　　【Abstract】 Objective To study the mechanism of Huangqi injection combined with Lamivudine in the treatment of hepatitis B virus associated glomerular nephritis (HBV-GN). Methods 55 HBV-GN patients were randomly assigned to the treatment group 30 cases and the control group 25 cases. The control group was treated with Lamivudine 100 mg/day, the treatment group, in addition to the above treatment, plus Huangqi injection 40 mL/day, the treatment course for both groups was 24 weeks. The grading of the symptoms was recorded before the treatment as well as at the 12th and 24th weeks. Results There was a significant difference of symptoms in two groups (Plt;0.01), the scores of appetite and abdominal distention were different in both groups (Plt;0.01), the scores of asthenia and edema in two groups has no difference (Pgt;0.01), the treatment group was superior to the control group on the comparison of symptoms and urinary protein curative effects. Conclusion Huangqi injection treatment combined with Lamivudine shows higher effects than the single Lamivudine treatment. 　　【Key words】 Huangqi injection; Lamivudine; Hepatitis B virus associated glomerular nephritis (HBV-GN); Clinical observation 　　目前，乙肝相关性肾炎（hepatitis B virus-associated glomerulo nephritis，HBV-GN）治疗尚无突破性进展，主要以抗病毒治疗为主。2003—2006年，我们应用黄芪注射液联合拉米夫定治疗HBV-GN 30例，并与单纯拉米夫定治疗25例对照观察，现报告如下。 　　1 资料与方法 　　1.1 一般资料 全部55例均为本院四病区门诊(26例)及住院（29例）患者，随机分为2组。治疗组30例，男17例，女13例；年龄15～58岁，平均38.6岁；病程1～8 年，平均3.8年。对照组25例，男14例，女11例；年龄13～59岁