CAJ | 학술논문

目的：研究小柴胡汤加减联合小剂量激素多靶点治疗难治性肾病综合征近期疗效及生化指标。方法选择难治性肾病综合征患者，随机分为给予小柴胡汤加减联合小剂量激素多靶点治疗的观察组和小剂量激素多靶点治疗的对照组，观察两组患者的治疗效果，检测血肌酐、血尿素氮、血红蛋白、内生肌酐清除率、24 h尿蛋白等肾功能相关指标和清蛋白、球蛋白、天门冬氨酸氨基转移酶（AST ）、丙氨酸氨基转移酶（ALT ）等肝功能指标。结果观察组患者治疗总有效率88．33％，疗效明显好于对照组；其血肌酐[（272．83±23．52）μmol/L]、血尿素氮[（9．32±1．12）μmol/L]、24 h尿蛋白[（0．12±0．01）g]、AST[（33．31±3．58）U/L]、ALT[（32．48±3．41）U/L]明显低于对照组，血红蛋白[（117．76±11．98）g/L]、内生肌酐清除率[（101．28±10．33）mL/min]、总蛋白[（69．82±7．32）g/L ]、清蛋白[（38．75±4．23）g/L ]明显高于对照组。结论小柴胡汤加减联合小剂量激素能够有效地改善肾功能、保护肝功能，对于提高治疗总体有效率具有积极意义。
목적：연구소시호탕가감연합소제량격소다파점치료난치성신병종합정근기료효급생화지표。방법선택난치성신병종합정환자，수궤분위급여소시호탕가감연합소제량격소다파점치료적관찰조화소제량격소다파점치료적대조조，관찰량조환자적치료효과，검측혈기항、혈뇨소담、혈홍단백、내생기항청제솔、24 h뇨단백등신공능상관지표화청단백、구단백、천문동안산안기전이매（AST ）、병안산안기전이매（ALT ）등간공능지표。결과관찰조환자치료총유효솔88．33％，료효명현호우대조조；기혈기항[（272．83±23．52）μmol/L]、혈뇨소담[（9．32±1．12）μmol/L]、24 h뇨단백[（0．12±0．01）g]、AST[（33．31±3．58）U/L]、ALT[（32．48±3．41）U/L]명현저우대조조，혈홍단백[（117．76±11．98）g/L]、내생기항청제솔[（101．28±10．33）mL/min]、총단백[（69．82±7．32）g/L ]、청단백[（38．75±4．23）g/L ]명현고우대조조。결론소시호탕가감연합소제량격소능구유효지개선신공능、보호간공능，대우제고치료총체유효솔구유적겁의의。
Objective To study the short term efficacy and the biochemical indexes of modified Xiaochaihu De-coction combined with small dose of hormone for conducting the multiple targets therapy on refractory nephrotic syn-drome .Methods The patients with refractory nephrotic syndrome were selected and randomly divided into the obser-vation group treated by the multi-target therapy of modified Xiaochaihu Decoction combined with small dose of hor-mone and the control group treated by the multi-target therapy of low dose hormone .The curative efficacies were ob-served .The renal function indexes of serum creatinine ,blood urea nitrogen ,hemoglobin ,endogenous creatinine clear-ance rate and 24 h urinary protein ,and the liver function indexes of albumin ,globulin ,aspartate aminotransferase (AST ) ,alanine aminotransferase(ALT ) were detected .Results The total effective rate in the observation group was 88 .33% ,the curative effect was obviously better than that in the control group ;serum creatinine[(272 .83 ± 23 .52)μmol/L] ,blood urea nitrogen[(9 .32 ± 1 .12)μmol/L] ,24 h urinary protein[(0 .12 ± 0 .01) g] ,AST [(33 .31 ± 3 .58) U/L],ALT[(32.48±3.41)U/L]intheobservaqtiongroupweresignificantlylowerthanthoseinthecontrolgroup ;while hemoglobin[(117 .76 ± 11 .98)g/L] ,endogenous creatinine clearance rate [(101 .28 ± 10 .33)mL/min] ,total protein[(69 .82 ± 7 .32)g/L] and albumin[(38 .75 ± 4 .23)g/L] in the observation group were significantly higher than those in the control group .Conclusion Modified Xiaochaihu Decoction combined with small dose of hormone can effectively improve the renal function ,protect the liver function and has the active significance to improve the o-verall effective rate for treating refractory nephrotic syndrome .