摘要
目的研究双倍剂量雷公藤多甙“顿挫”方式维持治疗原发性肾病综合征的效果及安全性。方法对60例原发性肾病综合征患者经双倍剂量(2mg/kg·d-1)诱导治疗持续4周(效果不佳者,诱导治疗持续8周)后,将诱导缓解患者随机分为A、B两组,A组进入双倍剂量“顿挫”方式进行维持治疗,口服剂量仍为2mg/kg·d-1,服2周停2周,交替进行,持续4～6个月后,减量为1mg/kg·d-1,仍为服2周停2周,交替持续至18个月;B组按常规方案进行维持治疗,减量为1.5mg/kg·d-1,14周后,减至1mg/kg·d-1持续至18个月。对比两组的临床疗效和副作用。结果诱导治疗缓解39例(缓解率65.00%),平均诱导时间6周,另外有11例达到改善,10例无效;39例诱导治疗缓解患者进入“顿挫”方式进行维持治疗,A组的复发率(15.00%)低于B组(47.38%),P=0.0407<0.05。结论双倍剂量雷公藤多甙对原发性肾病综合征的近期疗效确切,对皮质激素治疗无效的部分患者有效;“顿挫”方式维持治疗远期效果良好,复发率低。
Objective To observe the clinic al effect and reliability of d ouble dosage of Tripterygium Wilfordii (TW) with intermittent maintenance therap y in treatment of primary nephrotic syndrome. Methods Sixty patients with primary nephrotic syndrome were treated with TW in a double dosage of 2 mg/ kg·d^(-1) for 4 weeks orally (and for 8 weeks if the results below the mark) . The remitted patients (39 cases altogether) then were randomly allocated to two grou ps: group A (n=20) and group B (n=19). Group A was treated with a double dosage of TW with intermittent maintenance therapy, treatment period alternated with re sting period every two weeks and the dosage was the same. After 4～6 months, the patients were treated in a reduced dosage of 1 mg/kg·d^(-1) with intermitten t the rapy as mentioned above for 18 months. Group B was treated with normal regime in a dosage of 1.5 mg/kg·d^(-1) with maintenance therapy. And after 4 weeks, t he dosage was reduced to 1 mg/kg·d^(-1) for 18 months. A comparison of the c linical ef ficacy and side effect between group A and group B had been done. Results 39 cases (then were assigned to two groups and trea ted with different regime a s mentioned above) obtained remission after reducing therapy (the remission rate was 65.00%). The mean time of reduction was 6 weeks. Another 11 cases improved, and 10 cases were ineffective. The recurrence rate in group A (15.00%) was lowe r than that in group B (47.38%). There was statistically significant difference, P=0.0407<0.05. Conclusion The short-term e fficacy of double dosa ge of TW is certain in treatment of primary nephrotic syndrome and is effective in partial cortex hormone-resistant patients. The long-term effect of intermitte nt maintenance therapy regime was well with a low recurrence rate and was effect ive in treatment of primary nephrotic syndrome.
出处
《右江民族医学院学报》
2005年第3期282-284,共3页
Journal of Youjiang Medical University for Nationalities
关键词
肾病综合征
雷公藤属
股药和剂量
nephrotic syndrome
Tripterygium/administratio n and dosage
