百令胶囊辅助治疗肾病综合征的作用研究

发布时间：2018-06-21 02:57

本文选题：肾病综合征 + 百令胶囊　；参考：《湖北科技学院》2017年硕士论文

【摘要】：目的通过建立阿霉素肾病动物模型和收集肾病综合征患者资料,来从动物实验和临床试验两个方面来观察百令胶囊辅助治疗肾病综合征的疗效。方法1.动物实验:选用雄性SD大鼠,尾静脉注射阿霉素(ADR)4mg/kg,一周后改为2mg/kg。3周后取20只正常大鼠及60只造模成功的大鼠(测尿蛋白定量大于100mg/24h即造模成功),模型大鼠随机分为3组,后分别给药治疗。(1)正常对照组20只:正常饲养,不做特殊处理。(2)模型对照组20只:2ml生理盐水灌胃,每日一次。(3)泼尼松组20只:泼尼松2.5mg/kg与2ml生理盐水配置成混悬液灌胃,每日一次。(4)联合治疗组(D组)20只:用百令胶囊内容物350mg/kg和醋酸泼尼松2.5mg/kg与2ml生理盐水配制成混悬液灌胃,每日一次。给药4周观察大鼠24小时尿蛋白定量、血脂、血浆总蛋白(TP)、血白蛋白(ALB)、尿素氮(BUN)、肌酐(Scr)水平。2.临床试验:抽取收治的肾病综合征患者44例,观察组和对照组各22例。两组均予一般对症治疗(包括适当休息,低饱和脂肪、少盐、适量蛋白饮食及对症治疗)。(1)对照组予标准激素治疗方案,醋酸泼尼松起始剂量为1.0mg/(kg.d),最大用量不超过60mg/d,每日晨起顿服,连续服用8周,足量治疗后每1-2周减原用量的10%,减至20 mg/d时维持2~3个月,以后每14天减2.5~5mg,最后以最小有效剂量(10mg/d)作为维持量。(2)观察组基于对照组基础上加用百令胶囊,每次3粒(1.5g),3次/d,口服。治疗后1、3、6个月观察患者24小时尿蛋白定量、血脂、血浆总蛋白(TP)、血白蛋白(ALB)、尿素氮(BUN)、肌酐(Scr)水平及患者水肿情况。结果1、动物实验(1)与正常对照组相比,模型对照组24小时尿蛋白定量、血肌酐、尿素氮、甘油三酯、总胆固醇较高,血总蛋白、血白蛋白值较低,各项指标差异均具有统计学意义。(2)与模型对照组相比,醋酸泼尼松组24小时尿蛋白定量、血肌酐较低,血总蛋白、血白蛋白值较高,差异具有统计学意义(3)与模型对照组相比,醋酸泼尼松+百令胶囊内容物组24小时尿蛋白定量、血肌酐、尿素氮、甘油三酯、总胆固醇较低,血总蛋白、血白蛋白值较高,差异具有统计学意义。(4)与醋酸泼尼松组比较,加用百令胶囊内容物的联合治疗组各项生化指标更接近正常对照组值。24小时尿蛋白定量、甘油三酯、总胆固醇较低,血白蛋白值较高,差异具有统计学意义。其余指标无统计学差异。2、临床试验与对照组相比,观察组的24小时尿蛋白定量、甘油三酯、总胆固醇降低更明显,血浆总蛋白(TP)、血白蛋白(ALB)升高更明显。与对照组相比,观察组患者复发率更低,总有效率更高。结论百令胶囊辅助治疗NS效果优于单独使用醋酸泼尼松。
[Abstract]:Objective to establish the animal model of adriamycin nephropathy and collect the data of patients with nephrotic syndrome to observe the therapeutic effect of bailing capsule on nephrotic syndrome from two aspects: animal experiment and clinical trial. Method 1. Animal experiment: male SD rats were injected with adriamycin (adriamycin) 4 mg / kg via tail vein. After one week, 20 normal rats and 60 successful rats were selected for 2mg/kg.3 week. The rats were randomly divided into 3 groups. Then 20 rats in normal control group: normal feeding, no special treatment, 20 rats in model control group were perfused with 2 ml normal saline, once a day, 20 rats in prednisone group: prednisone 2.5mg/kg and 2ml normal saline were used as suspension perfused intragastrically, and the control group (n = 20) was treated with prednisone (n = 20), and the control group (n = 20) was perfused with normal saline (n = 20, n = 20). Group D (n = 20): suspension was made with 350mg/kg, prednisone acetate 2.5mg/kg and 2ml normal saline, once a day. After 4 weeks of administration, the levels of 24 hours urine protein, blood lipid, total plasma protein (TPN), serum albumin (ALBN), bun (bun), creatinine (SCR) were observed. Clinical trial: 44 cases of nephrotic syndrome, 22 cases of observation group and 22 cases of control group. Both groups were treated with general symptomatic therapy (including proper rest, low saturated fat, low salt, protein diet and symptomatic therapy). The control group was treated with standard hormone therapy. The initial dose of prednisone acetate was 1.0 mg / L / kg 路dL, the maximum dose was not more than 60 mg / d, taken daily in the morning, continuously for 8 weeks. After full treatment, 10% of the original dose was reduced every 1-2 weeks to 20 mg/d for 2 ~ 3 months. After 14 days, 2.5 mg / d was reduced, followed by a minimum effective dose of 10 mg / d as the maintenance dose.) in the observation group, bailing capsule was added on the basis of the control group, 3 tablets of 1. 5 mg / d each time, and taken orally for 3 / d of 1. 5 mg / d. The levels of 24 hour urine protein, serum lipids, plasma total protein (TPN), serum albumin (ALBN), bun (bun), creatinine (SCR) and edema were observed at 1 and 6 months after treatment. Results 1. Compared with the normal control group, the model control group had higher serum creatinine, urea nitrogen, triglyceride, higher total cholesterol and lower serum albumin. Compared with the model control group, the serum creatinine, total protein and albumin in prednisone acetate group were significantly higher than those in the model control group. Serum creatinine, urea nitrogen, triglyceride, total cholesterol, serum total protein and serum albumin were higher in prednisone acetate group (P < 0.05) and compared with prednisone acetate group (P < 0.05). The biochemical indexes of the combined treatment group were closer to the normal control group. 24 hours urine protein quantitative, triglyceride, total cholesterol was lower, the serum albumin value was higher, the difference was statistically significant. Compared with the control group, the 24 hour urinary protein quantity, triglyceride and total cholesterol in the observation group were lower than those in the control group, and the levels of TPN and ALB in plasma were higher in the observation group than in the control group. Compared with the control group, the recurrence rate was lower and the total effective rate was higher in the observation group. Conclusion Bering capsule is superior to prednisone acetate alone in the treatment of NS.
【学位授予单位】：湖北科技学院
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R692

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