| Objective: First reported the first case Combes, etc1971patients causedby blood transfusion hepatitis since and nephrotic syndrome, study of hepatitisB and kidney disease in the medical community of great importance to it.Symposium, held in October,1989, Beijing will be the disease called hepatitisB virus associated glomerulonephritis (HBV-GN). Refers to the hepatitis Bvirus infection after the body, through the glomerular immune reaction to formimmune complex injury, or the hepatitis B virus directly attack the kidneytissues and glomerular nephritis. Local deposition of immune complex, orimmune response due to in situ formation of immune complex may be thepathogenesis. Our country is hepatitis B virus (HBV) infection in high-riskareas, HBV carriers around10%or so. The incidence of HBV-designed. theGN and HBV infection rate level is roughly parallel. Children’s immunefunction is not fully development, HBV-designed. The GN rates significantlyhigher than the adult. HBV-GN is one of the more common secondary kidneydisease in our country, most of scholars at home and abroad think that HBVinfection is associated with a variety of pathological type ofglomerulonephritis. Common pathological types are MGN, MPGN, MCN.Clinical manifestations with nephrotic syndrome. Microscopic haematurianaked eye hematuria high blood pressure, etc. Similar to the same pathologicaltypes of primary glomerulonephritis. Because the original disease as hepatitiscan appear abnormal liver function, etc. Clinical manifestations, treatment isstill lack of effective treatment methods, different stories about the effect ofhormone and immune inhibitors. Some scholars think that hormones canpromote the risk of HBV replication in a cell, points out that in HBV activists unfavorable use. Interferon is a application for part of patients with HBV-designed. The GN has certain curative effect, but easy to relapse. And the drugtoxicity is larger, so in HBV is designed. The GN treatment is still a difficultproblem. Mentor TanJinChuan sorts through his clinical experience for manyyears, on the basis of syndrome differentiation and treatment, and combinedwith the patient’s individual situation, clear, hot and humid for nourishing liverand kidney invigorate the fights for the treatment of, choose B liver andkidney mixture treatment of the disease. Has achieved a satisfactorytherapeutic effect, for the Chinese medicine treatment of hepatitis B virusassociated nephropathy provides theory basis and the research train of thought.Methods: All observed cases from July2010-January2013clinicpatients in our department, diagnostic criteria with reference to the1989Beijing seminar suggested the hepatitis B virus associated glomerulonephritis.A total of50cases, according to random number table method were randomlydivided into treatment group (the control group (n=30), all patients were givento correct water and electrolyte acid-base balance disorder, hypertension, lowsalt, low fat, low quality protein food such as symptomatic treatment. To showthe nephrotic syndrome patients, application of glucocorticoid weighing thepros and cons of the hormone and immune inhibitors for patients. If the patientof hepatitis of inactivity, the hepatitis B virus replication, application ofhormone treatment, for two half-and-half big3this world and (or) HBV-DNApositive for the use of antiviral drugs. For hormone treatment is invalid ordependence on hormone in patients with recurrent or severe, or pathologicaltype characterized by focal segmental glomerular sclerosis fertile crescentnephritis membrane nephritis applications such as immunosuppressive therapy.Treatment group in the control group on the basis of treatment for nourishingliver and kidney, invigorate the circulation of fights for the solution of dampand hot, choose B hepatorenal mixture, serum virology in patients withHBV-designed. The GN (HBV-DNA) liver function (ALT, AST propagatedTC)24hours urine protein quantitative T lymphocyte subsets (CD4+, CD8+,CD4+/CD8+) and other laboratory results are studied. Observe the change of clinical symptom score, evaluate the clinical efficacy of the drug.Results:1Effective rate was79.17%in treatment group after treatment, controlgroup total effectiveness65.38%, compared two groups after treatment, thereare significant differences (P <0.05).2Two groups of patients after treatment symptoms curative effect havesignificant difference (P<0.05), the treatment group is better than the controlgroup.3Clinical symptoms integral comparison, the treatment group beforetreatment is16.27±2.68,8.54±1.21, after treatment, there were significantdifferences (P<0.01); Compared the control group before and after treatment,no significant difference (P>0.05).4Treatment group and control group from the point of dialecticalclassification, highest liver and kidney Yin deficiency syndrome, blood stasisjunction within the second, liver and gallbladder damp heat syndrome fromthe lowest proportion of pathological type, the highest membranousnephropathy, small lesions and to lowest membrane hyperplastic nephropathy.5Treatment group in reducing urinary protein elevated plasma albuminto protect liver function is better than that in control group, with statisticalsignificance (P <0.05).6Treatment group after treatment serum levels of CD4increasedsignificantly, compared with before treatment, there was statistical difference(P<0.05) in control group after treatment serum levels of CD4increasedsignificantly, compared with before treatment, there is statistical difference(P<0.05) in two groups after treatment compared with significant difference(P <0.05).7Treatment group after treatment serum CD8decreased obviously,compared with before treatment, there was statistical difference (P<0.05) incontrol group after treatment serum CD8decreased obviously, compared withbefore treatment, there is statistical difference (P<0.05) in two groups after treatment compared with significant difference (P<0.05).8Compared two groups after treatment, the treatment group of CD4+/CD8+increased significantly, compared with the control group, there wassignificant difference (P<0.05).Conclusions:1Clear, hot and humid for nourishing liver and kidney invigorate thefights for therapeutic principles, hepatorenal mixture is given priority to partyb treatment of hepatitis b virus associated nephritis, can obviously reduce thepatient’s clinical symptoms integral, its effect is better than the control group.2B hepatorenal mixture can improve the blood plasma albumin, reduceurinary protein quantitative, protection of liver function, improve clinicalsymptoms of patients.3B hepatorenal mixture can improve the serum levels of CD4, CD4/CD8levels to reduce the level of CD8, to explore the pathogenesis of hepatitisB virus associated nephropathy provides a new train of thought. |
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