雷公藤多苷治疗IgA肾病患者对其肾功能及肠道菌群相关指标的影响

doi:10.3969/j.issn.1671-7171.2022.06.007

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摘要【目的】探讨雷公藤多苷(TWM)治疗IgA肾病(IgAN)患者对其肾功能及肠道菌群相关指标的影响。【方法】170例IgAN患者随机分为观察组与对照组,每组85例。对照组给予泼尼松常规激素治疗,观察组在对照组基础上加用TWM治疗,比较两组患者临床疗效,治疗前后24 h尿蛋白(24hU-TP)及肾功能各项指标[血尿素氮(BUN)、血肌酐(SCr)、肌酐清除率(CCr)]、肠道菌群数(双歧杆菌、乳酸杆菌、大肠杆菌、肠球菌)和治疗期间不良反应发生情况。【结果】观察组治疗后总有效率为85.88%(73/85),显著高于对照组的65.88%(56/85),且差异有统计学意义(P<0.05)。两组患者治疗后24hU-TP、BUN、SCr均显著低于本组治疗前,CCr均显著高于本组治疗前(P<0.05);且观察组患者治疗后24hU-TP、BUN、SCr均显著低于对照组,CCr显著高于对照组(P<0.05)。治疗后,观察组双歧杆菌数量显著高于治疗前(P<0.05),两组乳酸杆菌数量均显著高于本组治疗前,大肠杆菌、肠球菌数量均显著低于本组治疗前(P<0.05);观察组患者治疗后双歧杆菌、乳酸杆菌数量均显著高于对照组,大肠杆菌、肠球菌数量均显著低于对照组(P<0.05)。两组患者治疗期间不良反应总发生率比较,差异无统计学意义(P>0.05)。【结论】在常规激素治疗的基础上加用TWM可有效治疗IgAN,可明显改善患者的肾功能及尿蛋白,且能通过有效改善肠道菌群失调来发挥其治疗IgAN的作用,且用药较为安全,值得临床推广。

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	卓鑫
	葛莉

关键词 ：雷公藤, 肾小球肾炎,IGA, 肾功能试验, 胃肠道微生物组

Abstract：【Objective】 To investigate the effect of Tripterygium wilfordii polyglycoside (TWM) on renal function and intestinal flora in patients with IgA nephropathy (IgAN). 【Methods】A total of 170 patients with IgAN were randomly divided into observation group and control group,with 85 cases in each group. The control group was treated with prednisone and the observation group was treated with TWM on the basis of the control group. The clinical efficacy,24h urinary protein (24hU-TP),various indexes of renal function [blood urea nitrogen (BUN),serum creatinine (SCr),creatinine clearance rate (CCr)],the number of intestinal flora (Bifidobacterium,Lactobacillus,Escherichia coli,Enterococcus) and the occurrence of adverse reactions during the treatment were compared between the two groups.【Results】The total effective rate of the observation group was 85.88% (73/85) significantly higher than that of the control group 65.88% (56/85),and the difference was statistically significant (P<0.05). The 24hU-TP,BUN and SCr of the two groups were significantly lower than those before treatment,and the CCr was significantly higher than that before treatment (P<0.05); The 24hU-TP,BUN and SCR in the observation group were significantly lower than those in the control group 24 hours after treatment,and the CCr was significantly higher than that in the control group (P<0.05). After treatment,the number of bifidobacteria in the observation group was significantly higher than that before treatment(P<0.05).The number of Lactobacillus in the two groups was significantly higher than that before treatment,and the number of Escherichia coli and Enterococcus were significantly lower than that before treatment (P<0.05); After treatment,the number of Bifidobacterium and Lactobacillus in the observation group was significantly higher than that in the control group,and the number of Escherichia coli and Enterococcus in the observation group was significantly lower than that in the control group (P<0.05).There was no significant difference in the total incidence of adverse reactions between the two groups(P>0.05). 【Conclusion】 On the basis of routine hormone therapy,TWM can effectively treat IgAN,can significantly improve the renal function and urinary protein of patients,and can play its role in the treatment of IgAN by effectively improving the imbalance of intestinal flora. The drug is relatively safe and worthy of clinical promotion.

Key words： TRIPTERYGIUM WILFORDII Glomerulonephritis,IGA Kidney Function Tests Gastrointestinal Microbiome

收稿日期: 2021-12-10

中图分类号:

R692.31

基金资助:陕西省科技厅项目(2021JM-472)

通讯作者: **E-mail:632991796@qq.com

引用本文:

卓鑫, 葛莉. 雷公藤多苷治疗IgA肾病患者对其肾功能及肠道菌群相关指标的影响[J]. 医学临床研究, 2022, 39(6): 823-826.
ZHUO Xin, GE Li. Effects of Tripterygium Wilfordii Polyglycoside on Renal Function and Intestinal Flora in Patients with IgA nephropathy. JOURNAL OF CLINICAL RESEARCH, 2022, 39(6): 823-826.

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http://journal07.magtech.org.cn/yxlcyj/CN/10.3969/j.issn.1671-7171.2022.06.007 或 http://journal07.magtech.org.cn/yxlcyj/CN/Y2022/V39/I6/823

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