基于激素联合环磷酰胺观察益气化瘀清热方序贯辨证治疗儿童难治性肾病综合征临床疗效  

Clinical efficacy of Yiqi Huayu Qingre Formula using sequential syndrome differentiation in the treatment of children with refractory nephrotic syndrome based on hormone combined with cyclophosphamide

作　　者：倪锦玉 翟文生[1,2] 李乐[1,3] 杨濛[1,3] 张秋月[1,3] NI Jin-yu;ZHAI Wen-sheng;LI Le;YANG Meng;ZHANG Qiu-yue(School of Pediatrics,Henan University of Traditional Chinese Medicine,Zhengzhou 450000,China;The First Affliated Hospital of Henan University of Traditional Chinese Medicine,Zhengzhou 450000,China)

机构地区：[1]河南中医药大学儿科医学院,郑州450000 [2]河南中医药大学第一附属医院儿科,郑州450000 [3]河南中医药大学第一附属医院,郑州450000

出　　处：《中华中医药杂志》2022年第12期7521-7525,共5页China Journal of Traditional Chinese Medicine and Pharmacy

基　　金：国家自然科学基金项目(No.81273803,No.81873339);河南省中医药科学研究专项重点项目(No.2017ZY1011);河南省特色学科中医学学科建设项目(No.STS-ZYX-2017007)。

摘　　要：目的:评价益气化瘀清热方序贯辨证治疗儿童难治性肾病综合征的临床疗效。方法:将105例难治性肾病综合征患儿随机分为观察组和对照组,观察组53例,对照组52例。对照组给予泼尼松片联合环磷酰胺治疗,观察组在对照组基础上加用益气化瘀清热方序贯辨证治疗。治疗时间为52周。观察治疗后的总有效率,治疗前后24h尿蛋白定量(24h UTP)、血浆白蛋白(ALB)、胆固醇(CHO)、甘油三酯(TG)、凝血[凝血酶原时间(PT)、活化部分凝血酶原时间(APTT)、纤维蛋白原含量(FIB)、D-二聚体(D-D)]、肝肾功能[谷丙转氨酶(ALT)、谷草转氨酶(AST)、尿素氮(BUN)、血肌酐(Cr)]的变化,观察治疗前后小儿难治性肾病中医生存质量量表积分的变化;记录不良反应。结果:观察组治疗后总有效率90.57%(48/53),显著高于对照组76.92%(40/52)(P<0.05);与本组治疗前比较,治疗后,两组患儿的24h UTP、CHO、TG、FIB、D-D均显著降低(P<0.05),ALB、PT、APTT均显著升高(P<0.05),且观察组改善更明显(P<0.01);两组患儿治疗前后ALT、AST、BUN、Cr无明显变化;治疗后两组中医生存质量量表生理功能、独立性因素、社会因素和总积分均显著增加(P<0.01),且观察组总分增加更明显(P<0.01);两组患儿均无明显不良反应。结论:益气化瘀清热方序贯辨证治疗儿童难治性肾病综合征可降低尿蛋白,升高ALB,降低血脂,改善高凝状态,能更好地提高患儿的生活质量。Objective:To evaluate the clinical efficacy of sequential syndrome differentiation of Yiqi Huayu Qingre Decoction in the treatment of refractory nephrotic syndrome in children.Methods:A total of 105 children with refractory nephrotic syndrome were randomly divided into observation group(53 cases)and control group(52 cases).The control group was treated with prednisone tablets combined with Cyclophosphamide,and the observation group was treated with sequential syndrome differentiation of Yiqi Huayu Qingre Decoction on the basis of the control group.The treatment time is 52 weeks.Observe the total effective rate after treatment.Observe the changes of 24 hours urine protein(24hUTP),albumin(ALB),cholesterol(CHO),triglyceride(TG),prothrombin time(PT),activated partial thromboplastin time(APTT),fibrinogen content(FIB),d-dimer(D-D),alanine aminotransferase(ALT),aspartate aminotransferase(AST),blood urea nitrogen(BUN)and serum creatinine(Cr)before and after treatment.Observe the changes in the scores of TCM inventory quality scales in children with refractory nephropathy before and after treatment.Record adverse reactions.Results:The total effective rate of the observation group was higher(P<0.05).Total effective rate of observation group 90.57%(48/53)after treatment was significantly higher than that of control group 76.92%(40/52)(P<0.05).Compared with before treatment,24hUTP,CHO,TG,FIB,D-D were significantly decreased(P<0.05),ALB,PT,APTT were significantly increased(P<0.05)in the two groups after treatment,and the observation group improved more significantly(P<0.05).There was no significant change in ALT,AST,BUN,Cr before and after treatment in the two groups of children.After treatment,the physiological function,independence factor,social factor and total score of the inventory quality scale of TCM in the two groups increased significantly(P<0.01),and the total score of the observation group increased more significantly(P<0.01).There were no obvious adverse reactions in the two groups of children.Conclusion:Sequentia

关 键 词：难治性肾病 中医生存质量量表 益气化瘀清热方 儿童 序贯辨证 

分 类 号：R272[医药卫生—中医儿科学]