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[目的]观察利水补肾方联合西药治疗难治性肾病综合征疗效。[方法]使用前瞻性设计,将200例门诊及住院患者行7~15mg/kg甲基泼尼松龙+250m L 9%生理盐水,1次/d,连用7d;8~12mg/kg环磷酰胺+250m L 9%生理盐水,环磷酰胺上限位200mg/kg,连用2d。利水补肾方(黄芪40g,当归、茯苓、滑石各20g;白术、陈皮、泽泻各10g,猪苓15g;脾虚湿重加山药30g,扁豆10g;脾肾阳虚加附片、桂枝各10g;肾阴虚加枸杞、龟板各15g,地骨皮10g,知母20g),1剂/d,水煎200m L,早晚口服。连续治疗7d为1疗程。观测临床症状、尿蛋白、血浆白蛋白、不良反应。连续治疗3疗程(21d),判定疗效。[结果]痊愈120例,显效52例,无效28例,总有效率86.00%。[结论]利水补肾方联合西药治疗难治性肾病综合征疗效满意,无严重不良反应,值得推广。
[Objective] To observe the therapeutic effect of Lishui Bushen Recipe combined with western medicine on refractory nephrotic syndrome. [Methods] Using 200 cases of outpatients and hospitalized patients, 7 outpatients and inpatients were treated with 7 ~ 15mg / kg methylprednisolone + 250ml L 9% normal saline once a day for 7d and 8 ~ 12mg / kg cyclophosphamide Amide + 250m L 9% saline, cyclophosphamide limit 200mg / kg, once every 2d. Lishui Bushen Fang (Astragalus 40g, Angelica, Poria, talcum of 20g; Atractylodes, Citrus, Alisma each 10g, Polyporus 15g; Spleen wet weight plus yam 30g, lentils 10g; ; Kidney plus wolfberry, turtle shell each 15g, Digupi 10g, Anemarrhena 20g), 1 / d, decoction 200m L, morning and evening oral. Continuous treatment 7d for a course of treatment. Clinical symptoms, urinary protein, plasma albumin, adverse reactions were observed. Continuous treatment of three courses (21d), determine the efficacy. [Result] 120 cases were cured, 52 cases markedly effective, 28 cases ineffective and the total effective rate was 86.00%. [Conclusion] Lishui Bushen Recipe combined with western medicine is effective in treating refractory nephrotic syndrome without serious adverse reactions and is worth promoting.