【摘要】 目的 :观察温肾固摄法对脾肾阳虚水泛型难治性肾病综合征患者血浆内皮素 (endothelin ,ET)和可溶性白介素 2受体(soluableinterleukin 2receptor ,sIL 2R)的影响。方法 :按就诊顺序随机分为两组 ,治疗组 2 4例 ,对照组 2 0例 ,对照组按标准方案服激素并递减剂量 (强的松 1mg·kg-1·d-1口服 ,8～ 12周后 ,每 2周减 5mg)的同时 ,环磷酰胺 (cyclophosphamide,CTX) 0 .8～ 1.0g加入 0 .9%生理盐水 2 0 0ml中静脉滴注 ,每 2周 1次 ,CTX总剂量为 6～ 8g ;治疗组在对照组治疗的基础上给予口服温肾固摄中药。结果 :治疗后血浆ET和sIL 2R含量都有不同程度改善 (P <0 .0 5 ) ,两组治疗后比较差异有显著性 (P <0 .0 5 )。结论 :难治性肾病综合征在常规治疗基础上加用温肾固摄法治疗 ,能改善肾脏血液循环 ,ET合成进一步降低 ,sIL 2R水平也得到改善 ,2 4h尿蛋白减少更多还原

【Abstract】 Objective:To explore the effect and mechanism of kidney-warming and astringent therapy in treating nephrotic syndrome patients with deficiency of spleen and kidney yang and overflow of water, and to observe the change of plasma endothelin and interleukin-2 receptor after treatment. Metheds:Forty-four patients were randomly divided into conventional steroid treated group (control group, 20 cases) and conventional steroid plus kidney-warming and astringent therapy treated group (treatment group, 24 cases). The levels of plasma endothelin (ET), soluable interleukin-2 receptor (sIL-2) were observed. Results:Before treatment, plasma ET and sIL-2 in the patients were significantly higher than those in healthy people(P< 0.01). After treatment, the ET and sIL-2 levels were obviously improved in both treated groups(P<0.05) and the improvement in the treatment group was more obvious. The difference between the two treated groups after treatment was significant(P< 0.05) . Conclusion:Conventional treatment plus kidney-warming and astringent therapy can effectively improve the levels of plasma ET and sIL-2 in treating nephrotic syndrome patients with deficiency of spleen and kidney yang and overflow of water, and hence alleviate the damage of renal tissue.更多还原