Clinical trial of multi glycosides of tripterygium wilfordii combined small dose of tacrolimus on idiopathic membranous nephropathy
10.13699/j.cnki.1001-6821.2015.11.003
- VernacularTitle:小剂量他克莫司联合雷公藤多苷治疗特发性膜性肾病的临床研究
- Author:
Jian-Yun PENG
1
;
Le-Jian LAN
;
Xiao-Ru ZHANG
Author Information
1. 温州医科大学 附属第六医院 肾内科
- Keywords:
idiopathic membranous nephropathy;
tripterygium wilfordii;
tacrolimus;
blood drug concentration;
adverse reaction
- From:
The Chinese Journal of Clinical Pharmacology
2015;(11):905-908
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the efficacy and safety of multi-target treatment of multi glycosides of tripterygium wilfordii combined small dose of tacrolimus on idiopathic membranous nephropathy.Methods A total of 40 cases with idiopathic membranous nephropathy were selected in our hospital and were randomly divided into two groups, 20 cases in control and treatment group, respectively.Patients in treatment group were given tacrolimus 0.05 mg· kg-1 · d-1 for the first time, maintaining the blood drug concentration at 2 to 5 ng · mL-1 , at the same time, tripterygium wilfordii 60 mg· d -1 were additionally given.After 6 months, the dose of tripterygium wilfordii was gradually reduced or stopped.While patients in control group were only administrated with tacrolimus with the initial dose of 0.1 mg· kg -1 · d-1 , maintaining the blood drug concentration at 5 to 10 ng· mL-1.After 6 months, the using of tacrolimus began to re-duce to maintain the concentration at 2 to 5 ng· mL-1.The data of cura-tive effect, adverse reaction and the concentration of tacrolimus in two groups were observed in 12 months.Results Compared with before treatment, the data of 24 h urinary protein, serum albumin and triglyceride were significantly improved in two groups ( P<0.05).After 12 -month of treatment, the data of 24 h urinary protein and serum albumin were statistically different between two groups ( P<0.05).After 6 months follow-up, the complete remission rate was 55% in treat-ment group, significantly higher than 30%in control group ( P<0.05).After 12 months follow-up, the recurrence rate in treatment group (17%) was lower than that in control group (41%, P<0.05).The incidence rate of adverse reactions between the two groups had no significant difference( P>0.05).Conclusion The multi-target treatment of small dose of tacrolimus combined tripterygium wilfordii for idiopathic membranous nephropathy has been confirmed with a faster onset, higher clinical remission rate, lower relapse rate, and patients are well tolerated.
