拉米夫定-来氟米特及中药联合治疗乙型肝炎病毒相关性膜性肾病临床探究.doc

拉米夫定\来氟米特及中药联合治疗乙型肝炎病毒相关性膜性肾病临床探究[摘要] 目的 探讨拉米夫定、来氟米特联合中药方剂治疗乙型肝炎病毒相关性膜性肾病（HBV-MN）的临床疗效。方法 患者均口服拉米夫定、来氟米特，研究组患者加服中药组方，治疗6个月，分别对经测血清白蛋白（ALB）、丙氨酸氨基转移酶（ALT）、血清胆固醇（CHO）、尿蛋白定量和临床疗效做出评价。结果 患者治疗6个月后，研究组ALT、CHO和尿蛋白定量[（45.8±10.3）、（5.7±1.4）、（1.5±1.3）]较对照组[（73.8±28.9）、（8.4±2.2）、（6.8±3.6）]均明显降低，ALB（33.9±5.3）较对照组（25.5±8.2）升高，数据经统计学比较具有显著差异（P＜0.05）。研究组患者经6个月中西结合治疗后总有效率（100.00%）明显高于对照组（77.27%）（P＜0.05）。结论 联合应用拉米夫定、来氟米特和中药治疗HBV-MN具有较好的临床疗效，能够更明显地改善ALB、ALT、CHO和尿蛋白定量，改善和调理患者肝、肾、脾的损伤。 [关键词] 拉米夫定；来氟米特；中药治疗；乙型肝炎；膜性肾病 [中图分类号] R692.9；R512.62[文献标识码] B [文章编号] 1673-9701（2011）25-81-02 Clinical Study of Hepatitis B Virus Associated Membranous Nephropathy Treated by Lamivudine，Leflunomide Combined with Chinese Medicine DUAN Yangri Hangzhou City Yuhang District the Third Peoples Hospital，Hangzhou 311115，China [Abstract] Objective To discuss the clinical effects of hepatitis B virus associated membranous nephropathy（HBV-MN） treated by lamivudine，leflunomide combined with Chinese medicine. Methods Patients were taken orally lamivudine and leflunomide. Study group added Chinese medicine for 6 months，then valued the ALB，ALT，CHO，urinary protein and clinical effects. Results Compared with Control Group（73.8±28.9，8.4±2.2，6.8±3.6），ALT，CHO and urinary protein of study group（45.8±10.3，5.7±1.4，1.5±1.3） were significantly reduced，ALB of study group （33.9±5.3） was higher than control group （25.5±8.27）（P＜0.05）. The total effective rate of study group（100%） was significantly higher than control group（77.27%）（P＜0.05）. Conclusion It has good effect of hepatitis B virus associated membranous nephropathy（HBV-MN） treated by lamivudine，leflunomide combined with Chinese medicine. It could significantly lower ALB，ALT，CHO，urinary protein and improve the hurt in liver，kidney，spleen of patients. [Key words] Lamivudine；Leflunomide；Chinese Medicine Treatment；Hepatitis B Virus；Membranous Nephropathy 乙型肝炎病毒相关性膜性肾病（Hepatitis B Virus Associated Membranous Nephropathy，HBV-MN）属于继发性肾小球疾病，在临床较为常见。对于HBV-MN的临床治