CAJ | 학술논문

目的：观察清肾方联合西药治疗活动期狼疮性肾炎的临床疗效。方法将60例活动期狼疮性肾炎患者随机分为2组，对照组30例采用波尼松＋环磷酰胺治疗，治疗组在对照组治疗基础上给予清肾方加减治疗。观察2组临床疗效，比较治疗前后SLE疾病活动指数（SLEDAI）积分、中医证候积分量化表（SLEFI）评分及实验室检查指标[血沉、24 h尿蛋白、血清白蛋白（ ALB）、尿红细胞、补体C3、补体C4、血清IgG、C反应蛋白（ CRP）、人高迁移率族蛋白B1（ HMGB1）、白细胞介素（ IL）－17及抗核抗体（ ANA）、抗双链DNA抗体（ ds－DNA）阳性率]的差异。结果治疗组临床总有效率明显高于对照组（ P＜0．05）。治疗后2组SLE-DAI积分、SLEFI评分及实验室各检查指标均较治疗前明显改善（ P均＜0．05），且除尿红细胞、ANA及ds－DNA阳性率外其余指标治疗组改善情况均明显优于对照组（ P均＜0．05）。治疗组不良反应发生率明显低于对照组（ P＜0．05）。结论清肾方联合西药治疗活动期狼疮性肾炎能明显改善患者临床症状及相关实验室指标，提高临床疗效，且安全性好。
목적：관찰청신방연합서약치료활동기랑창성신염적림상료효。방법장60례활동기랑창성신염환자수궤분위2조，대조조30례채용파니송＋배린선알치료，치료조재대조조치료기출상급여청신방가감치료。관찰2조림상료효，비교치료전후SLE질병활동지수（SLEDAI）적분、중의증후적분양화표（SLEFI）평분급실험실검사지표[혈침、24 h뇨단백、혈청백단백（ ALB）、뇨홍세포、보체C3、보체C4、혈청IgG、C반응단백（ CRP）、인고천이솔족단백B1（ HMGB1）、백세포개소（ IL）－17급항핵항체（ ANA）、항쌍련DNA항체（ ds－DNA）양성솔]적차이。결과치료조림상총유효솔명현고우대조조（ P＜0．05）。치료후2조SLE-DAI적분、SLEFI평분급실험실각검사지표균교치료전명현개선（ P균＜0．05），차제뇨홍세포、ANA급ds－DNA양성솔외기여지표치료조개선정황균명현우우대조조（ P균＜0．05）。치료조불량반응발생솔명현저우대조조（ P＜0．05）。결론청신방연합서약치료활동기랑창성신염능명현개선환자림상증상급상관실험실지표，제고림상료효，차안전성호。
Objective It is to observe the clinical efficacy of Qingshen prescription combined with western medicine on ac -tive lupus nephritis .Methods 60 patients with active lupus nephritis were randomly divided into two groups , the control group of 30 patients were treated with pure western medicine treatment ( prednison+cyclophosphamide ) , the treatment group were treated with Qingshen prescription additionally on the basis of treatment in control group .The clinical curative effect , changes of SLEDAI scores, SLEFI scores, and laboratory physical and chemical indicators such as ESR , 24 hour proteinuria, serum ALB, urine RBC, C3, C4, serum IgaG, CRP, HMGB1, IL-17 and ANA, ds-DNA positive rate before and after treatment were observed.Results The clinical total effective rate in treatment group was higher than that in control group (P<0.05). After treatment , SLEDAI scores , SLEFI scores and laboratory physical and chemical indicators in both groups were improved significantly (P all<0.05), the improvements of all the indicators except urine RBC , ANA and ds-DNA positive rate in treatment group were better than those in control group (P all<0.05).The occurrence rate of side effect in treatment group was lower than that in control group ( P<0.05) .Conclusion Qingshen prescription combined with western medicine can sig-nificantly improve the lupus nephritis patients ’ clinical symptoms , laboratory indexes and the clinical curative effect with good safety and feasibility .