益气养阴方联合肾上腺皮质激素对肾病综合征患儿体液免疫功能的影响  

Effect of Yiqi Yangyin Prescription Combined with Adrenocorticotropic Hormone on Humoral Immune Function of Children with Nephrotic Syndrome

作　　者：田明 刘翠华 厉洪江 TIAN Ming;LIU Cuihua;LI Hongjiang(Zhengzhou Children＇s Hospital,Zhengzhou Henan China 45000)

机构地区：[1]郑州儿童医院,河南郑州450000

出　　处：《中医学报》2018年第8期1580-1584,共5页Acta Chinese Medicine

基　　金：河南省郑州市科技攻关计划项目(112PPTSF307-1)

摘　　要：目的:观察益气养阴方药联合肾上腺皮质激素治疗肾病综合征的临床疗效以及对体液免疫功能的影响。方法:将110例肾病综合征患儿按随机数字表法分为观察组和对照组,每组55例。所有患儿均进行基础治疗及对症治疗,对照组患儿采用泼尼松治疗,观察组患儿在对照组治疗基础上加用益气养阴方治疗,方药组成:生黄芪、丹参、太子参15~25 g,山茱萸、党参、五味子、麦冬、白术10~15 g,川芎、赤芍、水蛭、熟大黄5~10 g。两组患儿均连续治疗两个月后比较临床疗效、中医证候积分、血清免疫球蛋白及补体C3水平、24小时尿蛋白定量、血清白蛋白(albumin,ALB)水平以及治疗期间的并发症发生情况。结果:观察组临床有效率为81.82%,对照组为69.09%,两组比较,差异有统计学意义(P<0.05);治疗后两组患儿中医证候积分均显著降低,且观察组显著低于对照组,差异均有统计学意义(P<0.05);治疗后两组患儿血清免疫球蛋白G(immune globlin,Ig G)、血清免疫球蛋白A(immune globlin,Ig A)、血清免疫球蛋白M(immune globlin,Ig M)水平均显著升高,且观察组显著高于对照组,差异有统计学意义(P<0.05);观察组完全缓解患者尿蛋白转阴时间,血ALB恢复正常时间均显著低于对照组,差异有统计学意义(P<0.05);观察组库欣综合征发生率为80.00%,对照组为90.91%,观察组显著低于对照组,差异有统计学意义(P<0.05),两组患儿痤疮、感染、高血压发生率比较,差异无统计学意义(P>0.05)。结论:益气养阴方联合肾上腺皮质激素能提升儿童肾病综合征的临床疗效,且临床症状及尿蛋白缓解效果更优,能显著提高患者的体液免疫功能,有效控制并发症发生。Objective： To observe the clinical efficacy of Yiqi Yangyin Prescription combined with adrenocortical hormone in treatment of Children＇s Nephrotic Syndrome and the effect on their humoral immune function. Methods： 110 children with nephrotic syndrome were divided into observation group and control group according to random number table,with 55 cases in each group.All patients were treated with basic treatment and symptomatic supportive treatment. The control group was treated with prednisone. The observation group was treated with Yiqi Yangyin Prescription in addition to that of the control group. The formula consisted of the followings： Raw astragalus,Salvia miltiorrhiza,Heterophylla,each 15-25 g; Hawthorn,Codonopsis,Schisandra,Ophiopogon japonicus,Atractylodes,each 10-15 g,Chuanxiong,Red peony root,Leeches,Cooked rhubarb,each 5-10 g. The two groups of children were treated for two consecutive months and the clinical efficacy,TCM syndrome scores,serum immunoglobulin and complement C3 levels,24-hour urinary protein quantification,serum albumin（ ALB） levels,and complications during treatment were compared. Results： The effective rate was 81. 82% in the observation group and 69. 09% in the control group. There was a statistically significant difference between the two groups（ P〈0. 05）. After treatment,the TCM syndrome scores of both groups were significantly lower,and the observation group was significantly lower than that of the control group（ P〈0. 05）. After treatment,the serum levels of immunoglobulin G（ Ig G）,serum immunoglobulin A（ Ig A）,and serum immunoglobulin M（ Ig M） in the two groups of children all increased significantly and that of the observation group was significantly higher than that of the control group（ P〈0. 05）. The observation group completely relieved the urinary protein negative time and the blood ALB recovery time was significantly lower than that of the control group（ P〈0. 05）. The incidence of Cushing syndrome was 80. 00% in the observation

关 键 词：肾病综合征 益气养阴方 肾上腺皮质激素 体液免疫 中医药疗法 中西医结合 

分 类 号：R259.692[医药卫生—中西医结合]