| 涂晓,杨梦蝶,李亚妤,等.昆仙胶囊与需公藤多苷片抬疗慢性肾脏病的疗效及安全性比较[J].浙江中医药大学学报,2021,45(6):582-587, 602. |
| 昆仙胶囊与需公藤多苷片抬疗慢性肾脏病的疗效及安全性比较 |
| Comparison of Efficacy and Safety of Kunxian Capsule and Tripterygium Glycoside Tablets in the Treatment of Chronic Kidney Disease |
| DOI：10.16466/j.issn1005-5509.2021.06.003 |
| 中文关键词: 慢性肾脏病 昆仙胶囊 雷公藤多苷片 系膜增生性肾炎 膜性肾病 糖尿病肾病 临床疗效 尿蛋白定量 |
| 英文关键词: chronic kidney disease Kunxian capsule Tripterygiumpoly glycoside tablets mesangial proliferative glomerulonephritis membranous nephropathy diabetic nephropathy clinical efficacy urine protein quantification |
| 基金项目:浙江省中医药科技计划项目(2021ZB209、2021ZA098) |
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| 中文摘要: |
| [目的]观察比较昆仙胶囊和雷公藤多苷片治疗慢性肾脏病的临床疗效及安全性。[方法]回顾性收集2017年1月至2019年12月于杭州市中医院门诊就诊的慢性肾脏病患者103例，根据治疗方案不同分为昆仙胶囊组、雷公藤多苷片组及对照组。对照组接受常规治疗；昆仙胶囊组在常规治疗基础上口服昆仙胶囊2粒/次，3次/d，疗程超过3个月；雷公藤多苷片组在常规治疗基础上口服雷公藤多苷片20mg/次，3次/d，疗程超过3个月。每组根据病理类型再分为系膜增生性肾炎(mesangial proliferative glomerulonephritis，MsPGN)组、膜性肾病(membranous nephropathy，MN)组、糖尿病肾病(diabetic nephropathy，DN)3个亚组，比较各组治疗前后临床疗效，血白细胞(white blood cell，WBC)、血小板(platelet，PLT)计数，以及24h尿蛋白定量、血肌酐(creatinine，Cr)水平、丙氨酸氨基转移酶(alanine aminotransferase，ALT)、血白蛋白(albumin，ALB)水平的差异。[结果]昆仙胶囊组治疗1、3个月后24h尿蛋白定量较治疗前均明显下降(P＜0.05)，治疗总有效率分别为75.7%、86.5%；雷公藤多苷片组治疗3个月后尿蛋白定量也明显下降(P＜0.05)，总有效率80.0%；两组治疗总有效率显著高于对照组(P＜0.05)，但两组之间差异无统计学意义(P＞0.05)。亚组分析中，昆仙胶囊组的三个亚组治疗后尿蛋白定量较治疗前均明显下降(P＜0.05)；雷公藤多苷片组仅MN亚组治疗后尿蛋白定量较治疗前下降明显(P＜0.05)。昆仙胶囊组及雷公藤多苷片组的MN亚组及DN亚组治疗后尿蛋白定量均显著低于对照组(P＜0.05)，但两种药物之间差异无统计学意义(P＞0.05)，但昆仙胶囊组的DN亚组起效时间早于雷公藤多苷片DN亚组。实验室指标方面，雷公藤多苷片组治疗后ALT较前升高，ALB较前下降，差异有统计学意义(P＜0.05)，而血PLT、WBC计数及昆仙胶囊组的上述各项指标治疗前后差异均无统计学意义(P＞0.05)。雷公藤多苷片组治疗后ALT水平高于对照组，而WBC、ALB水平低于对照组；昆仙胶囊组治疗后ALB水平低于对照组，差异均有统计学意义(P＜0.05)。[结论]昆仙胶囊及雷公藤多苷片均能明显降低慢性肾脏病患者尿蛋白水平，昆仙胶囊起效更快，能作用的病理类型更多，且安全性优于雷公藤多苷片。 |
| 英文摘要: |
| [Objective]To compare the clinical efficacy and safety of Kunxian capsule and Tripterygium glycoside tablets in the treatment of chronic kidney disease.[Methods]It retrospectively collected 103 outpatient regular follow-ups of Hangzhou Hospital of Traditional Chinese Medicine with chronic kidney disease from January 2017 to December 2019.According to different treatment schemes，these outpatients were divided into Kunxian capsule group， Tripterygium glycoside tablets group and control group.Patients in control group received routine treatment，Kunxian capsule group took two Kunxian capsules one time and three times a day on the basis of routine treatment at least 3 months，and Tripterygium glycoside tablets group took 20mg of Tripterygium glycoside tablets one time and three times a day on the basis of routine treatment at least 3 months.Each group was divided into mesangial proliferative glomerulonephritis(MsPGN) subgroup， membranous nephropathy(MN) subgroup， diabetic nephropathy(DN) subgroup according to pathological types.The clinical efficacy， white blood cell(WBC)， platelet(PLT) count， the levels of 24-hour urine protein quantification，creatinine(Cr)， alanine aminotransferase(ALT)， albumin(ALB) before and after treatment were compared.[Results]The 24-hour urine protein quantification in Kunxian capsule group decreased significantly after treatment for 1 month and 3 months(P＜0.05)，with the effective rates of treatment 75.7% and 86.5% respectively. In Tripterygium glycoside tablets group， the 24-hour urine protein quantification after 3 months of treatment decreased significantly compared with that before treatment(P＜0.05)，with the effective rate of treatment 80.0%.The total effective rate of the two groups was significantly higher than that of control group(P＜0.05)， but there was no significant difference between the two groups(P＞0.05). The 24-hour urine protein quantification also decreased significantly in all the subgroups of Kunxian capsule group(P＜0.05). The 24-hour urine protein quantification decreased significantly only in MN subgroups of Tripterygium glycoside tablets group(P＜0.05). The urine protein quantification in both MN and DN subgroups of Kunxian capsule group and Tripterygium glycoside tablets group were significantly lower than that of subgroup of control group(P＜0.05)，but there was no significant difference among the subgroups of Kunxian capsule group and Tripterygium glycoside tablets group(P＞0.05). However，Kunxian capsule had earlier onset in DN subgroup than Tripterygium glycoside tablets.The level of ALT of Tripterygium glycoside group increased and the level of ALB decreased significantly compared with before treatment(P＜0.05)，but there was no significant change in PLT， WBC count and these indexes of Kunxian capsule group before and after treatment(P＞0.05). The ALT level of Tripterygium glycoside tablets group was significant higher and WBC count， level of ALB was lower than that of control group， the ALB level of Kunxian capsule group was significant lower than that of control group(P＜0.05). [Conclusion]Both Kunxian capsule and Tripterygium glycoside tablets could significantly reduce the level of urine protein in patients with chronic kidney disease.Kunxian capsule can take quicker effect and function to more pathological types，and it's also safer than Tripterygium polyglycoside tablets. |
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