黄芪联合标准方案治疗小儿原发性肾病综合征随机平行对照研究  

Randomized,Paralleled and Contrapositive Trial of Astragalus Root combined Standard Treatment Protocols on Pediatric Primary Nephrotic Syndrome

作　　者：叶红[1] 钟伟恩 揭东英 

机构地区：[1]广东省廉江市人民医院儿科,广东廉江524400

出　　处：《实用中医内科杂志》2014年第9期25-27,共3页Journal of Practical Traditional Chinese Internal Medicine

摘　　要：[目的]观察黄芪联合标准方案治疗小儿原发性肾病综合征疗效。[方法]使用随机平行对照方法,将100例住院患者按随机数字表法随机分为两组。对照组50例强的松（1.5-2mg/（kgd）,≤60mg/d）,分3次/d,口服,定期规律减量;低分子右旋糖酐扩容、氢氯噻嗪及螺内酯利尿、双密达莫抗凝及阿洛西林抗感染等对症支持治疗;激素无效者加用环磷酰胺（累积剂100-200mg/kg）或雷公藤多甙片（1-1.52mg/（kgd）,累积量75-120 mg/kg）。治疗组50例黄芪颗粒,〈3岁,0.5包/;〉3岁,1包/次,2次/d;西药治疗同对照组。两组均连续治疗6个月为1疗程。观测临床症状、水肿消退时间、尿蛋白转阴时间、不良反应。治疗1疗程,判定疗效。[结果]治疗组治愈20例,显效16例,有效8例,无效6例,总有效率88.00%。对照组痊愈9例,显效8例,有效11例,无效22例,总有效率56.00%。治疗组疗效优于对照组（P〈0.05）。水肿消退时间及尿蛋白转阴时间治疗组优于对照组（P〈0.05）。[结论]黄芪联合标准方案治疗小儿原发性肾病综合征效果显著,值得推广。[ Objective ] To observe the effect of astragalus root combined standard treatment protocols on pediatric primary nephritic syndrome （ PNS ） . [ Methods ] 100 children with PNS were divided into two groups using randomized, paralleled and eontrapositive protocols, 50 in each group. In control group, prednisone （ 1.5 - 2mg/ （ kg.d ）,≤60mg/d ） was used, tid, po, and regular decrement. Other therapy including volume expanding with dextran-40, deuresis with hydrochlorothiazide and spironolactone, anticoagulation with dipyridamole and anti-infecting with azlocillin. Cyclophosphamide （ accumulated dose 100 - 200mg/kg ） or triptolide （ 1 - 1.52mg/ （ kg.d ）, accumulated dose 75 - 120 mg/kg ） was used if prednisone was invalid. In therapy group, astragalus root （ 0.5 - 1 bag/d, bid ） was used on the base of control group. Continues therapy for six months was one cycle. Clinical symptoms, time of oedema relief, time of urine protein reversion and adverse reaction were observed. Effect of treatment was decided after one therapeutic cycle. [ Results ] There were 20 restitution, 16 excellent, 8 effective and 6 invalidation in therapy group and 9 restitution, 8 excellent, 11 effective, 22 invalidation in control group. Total effective rate （ 88.00% ） in therapy group was higher than that （ 56.00% ） in control group significantly （ P〈0.05 ） . Time of oedema relief and urine protein reversion in therapy group was lower than that （ 56.00% ） in control group markedly （ P〈0.05 ） . [ Conclusion ] Astragalus root combined standard treatment protocols can enhance the therapeutic effect of pediatric primary nephritic syndrome.

关 键 词：小儿原发性肾病综合征 黄芪 强的松 低分子右旋糖酐 氢氯噻嗪 螺内酯 双密达莫 阿洛西林 环磷酰胺 雷公藤多甙 随机平行对照研究 

分 类 号：R256.5[医药卫生—中医内科学] R692[医药卫生—中医学]