Therapeutic efficacy of tripterygium glycosides combined with tacrolimus and hormone in treatment of refractory nephrotic syndrome and its effects on serum levels of sTNF-R1,IGFBP-2 and CFH
Objective To explore the the efficacy of tripterygium glycosides combined with tacrolimus and hormone therapy in treatment of refractory nephrotic syndrome(RNS)and its effects on serum levels of soluble tumor necrosis factor receptor 1(sTNF-R1),insulin-like growth factor binding protein-2(IGFBP-2)and complement factor H(CFH).Methods The research subjects were 102 patients with RNS admitted to the Affiliated Hospital of Jiangnan University from August 2018 to August 2021,and they were divided into the control group(n=51,treated with methylprednisolone tablet and tacrolimus capsule)and the observation group(n=51,treated with tripterygium glycosides tablet based on the regimen in the control group)by the random number table method.The therapeutic effect and serum-related indicators were evaluated and the adverse reactions counted in both groups.Results The total effective rate of treatment in the observation group(94.12%)was higher than that in the control(78.43%)(χ2=5.299,P=0.021).After treatment,the levels of serum albumin and CFH in the observation group were(36.54±8.11)g·L-1 and(586.20±100.72)μg·mL-1,which were higher than those of(32.58±6.12)g·L-1 and(540.11±100.47)μg·mL-1 in the control(t=2.783,P=0.006;t=2.314,P=0.023).The levels of 24 h urinary protein,creatinine,sTNF-R1 and IGFBP-2 were(2.67±0.69)g,(82.25±16.13)μmol·L-1,(1.56±0.45)ng·mL-1 and(51.34±10.44)ng·mL-1 in the observation group,which were lower than those of(3.24±1.02)g,(92.68±17.35)μmol·L-1,(1.91±0.58)ng·mL-1 and(57.79±12.58)ng·mL-1 in the control(t=3.306,P=0.001;t=3.135,P=0.002;t=3.405,P=0.001;t=2.820,P=0.005).The recurrence rate in the observation group was 1.96%,which was lower than that of 13.73%in control(χ2=4.883,P=0.027).Conclusion Tripterygium glycosides combined with tacrolimus and hormone has a good therapeutic effect on RNS because it can reduce the recurrence rate,improve the renal function and relieve the inflammation.Therefore,it is expected to be used as adjuvant therapy for RNS.
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