护肾康复汤辅助激素治疗小儿复发性肾病综合征48例  

Clinical Observation of Hushen Kangfu Decoction for Assistance of Hormone in Treating 48 Children with Recurrent Pediatric Nephrotic Syndrome

作　　者：黄可丹[1] 

机构地区：[1]河南省中医院,郑州450002

出　　处：《中国实验方剂学杂志》2015年第12期170-173,共4页Chinese Journal of Experimental Traditional Medical Formulae

摘　　要：目的:探讨护肾康复汤辅助激素治疗脾虚湿困型小儿复发性肾病综合征(PNS)的临床疗效及对血清炎性因子和血液高凝状态的影响。方法:将96例患儿随机按住院前后顺序分为观察组和对照组各48例。对照组采用激素治疗,观察组加用护肾康复汤辨证治疗。两组疗程均为4个月。检测24 h尿蛋白定量、血浆总蛋白(TP),白蛋白(ALB),总胆固醇(TC)和甘油三脂(TG)水平;检测纤维蛋白原(FIB),D-二聚体(D-D),血小板聚集率(MPAR),肿瘤坏死因子-α(TNF-α),超敏C-反应蛋白(hs-CRP),白细胞介素-6(IL-6)水平,治疗前后各评价1次;并监测心、肝、肾等安全性指标。结果:经Ridit分析,治疗后观察组临床疗效优于对照组(P<0.05);治疗后观察组24 h尿蛋白定量,TC和TG低于对照组(P<0.01),TP和ALB水平均高于对照组(P<0.01);治疗后观察组FIB,D-D和MPAR水平均低于对照组(P<0.01);治疗后观察组TNF-α,hs-CRP,IL-6水平均低于对照组(P<0.01)。结论:护肾康复汤辅助激素治疗儿童复发性PNS(脾虚湿困型)临床疗效优于单纯西医治疗,其作用机制可能与减轻炎症反应,调节脂代谢,改善血液高凝状态有关。Objective： To discuss the adjuvant effect of Hushen Kangih decoction for assistance of hormone in treating recurrent pediatric nephrotic syndrome （PNS） disease of splenasthenic hygrosis type, and to investigate its influence on serum inflammatory factors and high blood coagulation state. Method： Ninety-six patients were randomly divided into the observation group （48 cases） and the control group （48 cases） via a digital method. Patients in the control group received hormone therapy, and patients in the observation group added I-Iushen Kanghu decoction. All patients in both two groups received 4 months of treatment. Levels of 24 h urine protein, total protein （TP） , albumin （ALB） , total cholesterol （ TC ） , triglycerides （TG） , fibrinogen （ FIB ） , D-dimer （D-D）, platelet aggregation rate （ MPAR）, tumor necrosis factor-a （TNF-a）, hypersensitive C-reactive protein （hs-CRP） and interleukin 6 （IL-6） were detected before and after therapy. Besides, safety indicators of heart, liver and kidney were monitored. Result： The clinical curative effect in the observation group was superior to that in the control group （P 〈 0.05）. After treatment, levels of 24 h urine protein, TG and TC in the observation group were lower （P 〈 0.01 ） , while standards of TP and ALB were higher （P 〈 0.01 ） than those in the control group. Standard of FIB, D-D and MPAR in the observation group were inferior to those in the control group after therapy （P 〈 0.01 ）. Besides, levels of TNF-α, hs-CRP and IL-6 in the observation group were lower than those in the control group （P 〈 0.01 ）. Conclusion： The clinical curative effect of hormone assisted with Hushen Kangfu decoction was superior to using Western therapy alone in treating recurrent PNS children. Its mechanism may be related to reducing inflammation, regulating lipid metabolism, enhancing blood high condensation state.

关 键 词：肾病综合征 脾虚湿困型 护肾康复汤 炎症因子 高凝状态 

分 类 号：R287[医药卫生—中药学]