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目的探讨黄芪注射液联合拉米夫定治疗乙型肝炎相关性肾炎(HBV-GN)的疗效及作用机制。方法将55例HBV-GN患者按双盲法随机分为2组,对照组25例予拉米夫定100 mg,每日1次口服,治疗组30例在对照组的基础上加用黄芪注射液40 mL,每日1次静脉滴注。2组均24周为1个疗程。2组均在治疗前、治疗第122、4周及随访6个月后行症状积分评定各1次,并观察2组临床疗效。结果2组治疗后各症状积分与本组治疗前比较差异均有统计学意义(P<0.01);2组治疗后食欲及腹胀积分比较差异均有统计学意义(P<0.01),乏力及水肿积分比较差异无统计学意义(P>0.01)。2组证候及尿蛋白疗效比较差异均有统计学意义(P<0.05)。其他实验室指标疗效比较差异无统计学意义(P>0.05)。结论黄芪注射液联合拉米夫定治疗HBV-GN在改善证候及尿蛋白方面优于单纯拉米夫定治疗。
Objective To investigate the therapeutic effect and mechanism of Astragalus injection plus lamivudine on hepatitis B-associated nephritis (HBV-GN). Methods Fifty-five patients with HBV-GN were randomly divided into two groups according to double-blind method. In the control group, 25 patients were given lamivudine 100 mg orally once daily. Thirty patients in the treatment group were given astragalus injection on the basis of the control group Liquid 40 mL, 1 intravenous infusion. 2 groups were 24 weeks for a course of treatment. Two groups were evaluated before treatment, 122nd and 4 weeks after treatment and 6 months after treatment respectively. The symptom score was evaluated one time and the clinical curative effect was observed in two groups. Results The score of each symptom after treatment was significantly different from that before treatment in both groups (P <0.01). There was significant difference in appetite and bloating score between the two groups after treatment (P <0.01), fatigue and edema There was no significant difference between the scores (P> 0.01). There was significant difference in the curative effect between two groups of syndromes and urinary protein (P <0.05). There was no significant difference in other laboratory indexes (P> 0.05). Conclusion Astragalus injection plus lamivudine is superior to lamivudine alone in improving the syndrome and urinary protein in patients with HBV-GN.