CAJ | 학술논문

目的：本研究旨在中医辨证论治的基础上，观察自拟养阴清热、活血利水中药治疗狼疮性肾炎的临床疗效，以探讨狼疮性肾炎的中西医结合方法。方法：收集上海中医药大学附属市中医医院风湿科病房及门诊狼疮性肾炎病例共95例，分为中医组、西医组和中西医结合组，其中中医组31例，西医组31例，中西医结合组33例。中医组服中药组方（生地、丹参、接骨木、积雪草、猫爪草等）每日1剂，分两次口服；西医组静脉滴注环磷酰胺0．6~1．0 g/月；中西医结合组在口服中药组方的基础上静脉滴注环磷酰胺0．6 g/月。各组病例均分别治疗6、12个月，观察三组治疗前后各项指标的变化，并做出统计分析。结果：三组疾病疗效判定西医组总有效率为80．65%，中医组总有效率为83．87%，中西医组总有效率为96．88%。三组疾病疗效经比较提示中西医组疾病疗效分别优于中医组和西医组（ P﹤0．05）。结论：养阴清热、活血利水中药具有一定的抑制免疫作用。中药联合环磷酰胺治疗狼疮性肾炎可以更有效控制病情，提高临床疗效。
목적：본연구지재중의변증론치적기출상，관찰자의양음청열、활혈이수중약치료랑창성신염적림상료효，이탐토랑창성신염적중서의결합방법。방법：수집상해중의약대학부속시중의의원풍습과병방급문진랑창성신염병례공95례，분위중의조、서의조화중서의결합조，기중중의조31례，서의조31례，중서의결합조33례。중의조복중약조방（생지、단삼、접골목、적설초、묘조초등）매일1제，분량차구복；서의조정맥적주배린선알0．6~1．0 g/월；중서의결합조재구복중약조방적기출상정맥적주배린선알0．6 g/월。각조병례균분별치료6、12개월，관찰삼조치료전후각항지표적변화，병주출통계분석。결과：삼조질병료효판정서의조총유효솔위80．65%，중의조총유효솔위83．87%，중서의조총유효솔위96．88%。삼조질병료효경비교제시중서의조질병료효분별우우중의조화서의조（ P﹤0．05）。결론：양음청열、활혈이수중약구유일정적억제면역작용。중약연합배린선알치료랑창성신염가이경유효공제병정，제고림상료효。
Objective:In this study,clinical efficacy on lupus nephritis treated with clearing away heat,activating blood and promoting diuresis decoction was observed on the basis of syndrome differentiation,in order to discuss new integrative lupus ne-phritis treatment. Methods:We collected 95 lupus nephritis cases from rheumatology department and outpatient of shanghai municipal TCM hospital affliated to shanghai TCM university. They were divided into chinese medicine group(31 cases),western medicine group(31 cases)and integrative medicine group(33 cases). Chinese medicine group:traditionnal chinese medicine decoction (shengdi,danshen,jiegumu,jixuecao,maozhuacao,etc)taken twice a day;Western medicine group:intravenous cyclophospha-mide 0. 6~1. 0/month;Integrative medicine group:chinese medicine decoction plus intravenous cyclophospha mide 0. 6/month. All the patients were treated 6 months and 12 months respectively. SLEDAI scores and laboratory indicators before and after treatment in the three groups were observed,and then statistical analysis was made. Results:In respect of disease efficacy assessment,total effica-cy rate in chinese medicine group was 83. 87%,80. 65% in western medicine group,and 96. 88% in integrative one,indicating the integrative group had better efficacy rate than the other two(P﹤0. 05). Conclusion:TCM decoction of nourishing yin and clearing a-way heat,activating blood and promoting diuresis has some immunosuppressive effect. Integrative treatment of lupus nephritis com-bined with TCM and cyclophosphamide can control the disease more effectively,and enhance clinical efficacy.