紫癜汤加减治疗儿童紫癜性肾炎血热妄行证45例临床观察  

Clinical observation on 45 cases of henoch-schonlein purpura nephritis in children with reckless flow of blood due to blood-heat syndrome treated by modified Zidian Tang(紫癜汤)

作　　者：王一鸣 童一川 WANG Yiming;TONG Yichuan(Department of Pediatrics,Shengzhou Maternal and Child Health Hospital,Shengzhou,Zhejiang,312400,China;Department of TCM,Shangyu The People's Hospital,Shangyu,Zhejiang,312300,China)

机构地区：[1]嵊州市妇幼保健院儿科,浙江嵊州312400 [2]上虞市人民医院中医科,浙江上虞312300

出　　处：《中医儿科杂志》2022年第3期72-76,共5页Journal of Pediatrics of Traditional Chinese Medicine

摘　　要：目的 观察紫癜汤加减治疗儿童紫癜性肾炎(HSPN)血热妄行证的临床疗效。方法 选取2018年12月至2020年12月嵊州市妇幼保健院儿科收治的HSPN血热妄行证患儿90例,采用随机数字表法分为对照组和治疗组,各45例。对照组予双嘧达莫片、卡托普利片、醋酸泼尼松龙片口服,治疗组在对照组治疗方法的基础上给予紫癜汤加减治疗。2组均30 d为1个疗程,治疗2个疗程后统计疗效。结果 对照组总有效率为75.56%(34/45),治疗组为91.11%(41/45),2组比较,差异有统计学意义(P<0.05)。治疗前,2组主症、次症积分及中医证候总积分比较,差异无统计学意义(P>0.05),具有可比性;治疗后,2组上述积分均显著下降,与同组治疗前比较,差异有统计学意义(P<0.05),且治疗组下降更显著(P<0.05)。治疗前,2组24 h尿蛋白定量、每高倍镜下红细胞计数、β微球蛋白(β-MG)水平比较,差异无统计学意义(P>0.05),具有可比性;治疗后,2组上述指标均显著下降,与同组治疗前比较,差异有统计学意义(P<0.05),且治疗组下降更显著(P<0.05)。治疗前,2组CD3^(+)、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+)水平比较,差异无统计学意义(P>0.05),具有可比性;治疗后,2组CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)水平明显升高,CD8^(+)水平明显下降,与同组治疗前比较,差异有统计学意义(P<0.05),且治疗组升高或下降更显著(P<0.05)。结论 紫癜汤加减治疗儿童HSPN血热妄行证,能明显缓解临床症状,减轻血尿和蛋白尿,调节免疫功能及保护肾功能,疗效显著,值得临床推广应用。Objective To observe the clinical efficacy of modified Zidian Tang(紫癜汤)in the treatment of henoch-schonlein purpura nephritis(HSPN)in children with reckless flow of blood due to blood-heat syndrome.Methods From December 2018 to December 2020,90 cases of HSPN in children with reckless flow of blood due to blood-heat syndrome admitted into pediatrics department of Shengzhou Maternal and Child Health Hospital were divided into control group and treatment group according to random number table method,with 45 cases in each group.The control group was given oral administration of dipyridamole tablets,captopril tablets and prednisolone acetate tablets;On this basis,the treatment group was given modified Zidian Tang.Thirty days constituted 1 course of treatment for both groups,and we kept statistics about the efficacy after 2 courses of treatment.Results The total effective rate of the control group was 75.56%(34/45),that of the treatment group was 91.11%(41/45),and the difference was statistically significant between the 2 groups(P<0.05).Before treatment,the differences were not statistically significant in cardinal symptom score,assident symptom score and TCM syndrome total score between the 2 groups(P>0.05),indicating comparability.After treatment,the above-mentioned scores in the 2 groups all significantly decreased,and the differences were statistically significant than those in the same group before treatment(P<0.05),moreover,the decrease was more significant in the treatment group(P<0.05).Before treatment,there were no statistically significant differences in 24 hours urine protein quantity,erythrocyte count per field of view at high magnification andβ-microglobulin(β-MG)level between the 2 groups(P>0.05),indicating comparability.After treatment,the above-mentioned indexes in the 2 groups decreased significantly,and the differences were statistically significant than those in the same group before treatment(P<0.05),and the decrease in the treatment group was more significant(P<0.05).Before treatment,there

关 键 词：紫癜性肾炎 儿童 血热妄行证 紫癜汤 临床观察 

分 类 号：R692.3[医药卫生—泌尿科学]