消风散合凉血五根汤联合西药治疗成人过敏性紫癜性肾炎临床疗效及对患者血表皮生长因子、血小板活化因子乙酰水解酶的影响  

Clinical effect of Xiaofeng powder and Liangxue Wugen decoction combined with western medicine on adult henoch-schonlein purpura nephritis and its effect on blood epidermal growth factor and platelet activating factor acetylhydrolase

作　　者：王月美[1] 师小萌[1] 边莉[1] 张立欣[1] 白艳秋[1] WANG Yuemei;SHI Xiaomeng;BIAN Li(Department of Dermatology,Shijiazhuang Hospital of Traditional Chinese Medicine,Shijiazhuang,Hebei 050051)

机构地区：[1]河北省石家庄市中医院皮肤科,河北石家庄050051

出　　处：《河北中医》2020年第1期57-62,共6页Hebei Journal of Traditional Chinese Medicine

基　　金：2017年度河北省中医药管理局科研计划项目(编号:2017111)。

摘　　要：目的观察消风散合凉血五根汤联合西药治疗成人过敏性紫癜性肾炎(HSPN)的临床疗效及对患者血表皮生长因子(EGF)、血小板活化因子乙酰水解酶(PAF-AH)的影响。方法将90例成人HSPN患者按照随机数字表法分为2组。对照组45例予常规西医治疗;治疗组45例在对照组基础上加服消风散合凉血五根汤治疗。2组均治疗8周。比较2组治疗前后中医证候评分、血肌酐(Cr)、尿素氮(BUN)、24 h尿蛋白定量、尿红细胞计数(U-RBC)、尿微量白蛋白尿肌酐比值(UACR)、估算肾小球滤过率(e GFR)、血EGF、PAF-AH水平,并统计2组临床疗效及不良反应情况。结果治疗组总有效率88.89%,对照组总有效率68.89%,治疗组疗效优于对照组(P<0.05)。治疗后2组各项中医证候评分及总分均降低(P<0.05),治疗组治疗后各项中医证候评分及总分均低于对照组(P<0.05)。治疗后2组Cr、BUN、24 h尿蛋白定量、U-RBC、UACR均降低(P<0.05),e GFR升高(P<0.05);治疗组治疗后Cr、BUN、24 h尿蛋白定量、U-RBC、UACR均低于对照组(P<0.05),e GFR高于对照组(P<0.05)。治疗后2组血EGF、PAF-AH水平均降低(P<0.05),治疗组治疗后血EGF、PAF-AH水平均低于对照组(P<0.05)。治疗组不良反应率(11.11%)低于对照组(26.67%,P<0.05)。结论成人HSPN在西医治疗基础上,加用消风散合凉血五根汤可提高临床疗效,不仅可改善临床症状,还能改善肾功能,降低糖皮质激素不良反应,其机制之一可能与其下调血EGF、PAF-AH水平有关。Objective To observe the effect of Xiaofeng powder and Liangxue Wugen decoction combined with western medicine on adult henoch-schonlein purpura nephritis(HSPN)and its effect on blood epidermal growth factor(EGF)and platelet activating factor acetylhydrolase(PAF-AH).Methods 90 adult HSPN patients were divided into two groups according to random number table method.45 cases in control group were treated by conventional western medicine.45 cases in treatment group were treated by Xiaofeng powder and Liangxue Wugen decoction on the basis of the control group.Both groups were treated for 8 weeks.The TCM syndrome score,blood creatinine(Cr),urea nitrogen(BUN),24 h urine protein quantity,urine red blood cell count(U-RBC),urine microalbuminuria creatinine ratio(UACR),estimated glomerular filtration rate(eGFR),blood EGF,PAF-AH levels were compared between the two groups before and after treatment,and the clinical efficacy and adverse reactions of the two groups were counted.Results The total effective rate was 88.89%in treatment group and 68.89%in control group.The clinical curative effect of the treatment group was better than that of the control group(P<0.05).After treatment,the scores and total scores of TCM syndromes in two groups were lower than those in the group before treatment(P<0.05).After treatment,the scores and total scores of TCM syndromes in the treatment group were lower than those in the control group(P<0.05).After treatment,Cr,BUN,24 h urine protein quantity,U-RBC,UACR in two groups were decreased(P<0.05),eGFR was increased(P<0.05).The Cr,BUN,24 h urine protein quantity,U-RBC,UACR in the treatment group were lower than those in the control group(P<0.05),eGFR was higher than those in the control group(P<0.05).After treatment,the levels of EGF and PAF-AH in the two groups were decreased(P<0.05),and the levels of EGF and PAF-AH in the treatment group were lower than those in the control group(P<0.05).The adverse reaction rate of the treatment group(11.11%)was lower than that of the control group(26.67%,P<0.

关 键 词：消风散 凉血 紫癜 过敏性 肾炎 中西医结合疗法 

分 类 号：R692.340.58[医药卫生—泌尿科学]