目的 探究芪地桃蛭二蝉方联合他克莫司治疗膜性肾病的效果及对抗磷脂酶A2 受体(PLA2R)、B淋巴细胞活化因子(BAFF)及白细胞介素-6(IL-6)水平的影响.方法 选取2017年 11月至 2020 年4 月收治的84例膜性肾病患者为研究对象,将其随机分为对照组与联合组,各42 例.对照组给予基础治疗加他克莫司治疗,联合组在对照组基础上加芪地桃蛭二蝉方治疗.比较两组的治疗效果.结果 联合组的治疗总有效率高于对照组,差异具有统计学意义(P＜0.05).治疗前,两组的 24h尿蛋白定量(24 h UPQ)、人血清白蛋白(HSA)、血清肌酐浓度(Scr)水平比较,差异无统计学意义(P＞0.05);治疗后,两组的 24 h UPQ、Scr水平均明显降低,HSA水平均明显升高,且联合组优于对照组,差异具有统计学意义(P＜0.05).治疗前,两组的PLA2R、BAFF及IL-6 水平比较,差异无统计学意义(P＞0.05);治疗后,两组的PLA2R、BAFF及IL-6 水平均明显降低,且联合组低于对照组,差异具有统计学意义(P＜0.05).联合组的不良反应总发生率低于对照组,差异具有统计学意义(P＜0.05).结论 芪地桃蛭二蝉方联合他克莫司治疗膜性肾病效果显著,能够明显降低PLA2R、BAFF及IL-6 水平,安全可靠,值得推广.
Effect of Qidi Taozhi Erchan recipe combined with tacrolimus in the treatment of membranous nephropathy and its influences on serum PLA2R,BAFF and IL-6 levels
Objective To explore the effect of Qidi Taozhi Erchan recipe combined with tacrolimus in the treatment of membranous nephropathy and its influences on phospholipase A2 receptor(PLA2R),B lymphocyte activating factor(BAFF)and interleukin-6(IL-6)levels.Methods A total of 84 patients with membranous nephropathy admitted from November 2017 to April 2020 were selected as the study objects,and the patients were randomly divided into control group and combined group,with 42 cases in each group.The control group was treated with basic treatment and tacrolimus,and the combined group was treated with Qidi Taozhi Erchan recipe on the basis of the control group.The therapeutic effects of the two groups were compared.Results The total effective rate of treatment in the combined group was higher than that in the control group,and the difference was statistically significant(P<0.05).Before treatment,there were no significant differences in the levels of 24 hours urine protein quantification(24 h UPQ),human serum albumin(HSA)and serum creatinine concentration(Scr)between the two groups(P>0.05);after treatment,the levels of 24 h UPQ and Scr in the two groups significantly decreased,the level of HSA significantly increased,those in the combined group were better than the control group,and the differences were statistically significant(P<0.05).Before treatment,there were no significant differences in the levels of PLA2R,BAFF and IL-6 between the two groups(P>0.05);after treatment,the levels of PLA2R,BAFF and IL-6 in the two groups significantly decreased,those in the combined group were lower than the control group,and the differences were statistically significant(P<0.05).The total incidence of adverse reactions in the combined group was lower than that in the control group,and the difference was statistically significant(P<0.05).Conclusion Qidi Taozhi Erchan recipe combined with tacrolimus in the treatment of membranous nephropathy has a significant effect,it can significantly reduce the levels of PLA2R,BAFF and IL-6,which is safe,reliable and worthy of promotion.
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