健脾清热解毒方联合常规疗法治疗湿热瘀毒内阻型小儿紫癜性肾炎临床研究  

Clinical Study on Jianpi Qingre Jiedu Prescription Combined with Routine Therapy for Henoch-Schionlein Purpura Nephritis of Internal Obstruction of Damp-Heat, Blood Stasis and Toxin Type in Children

作　　者：张龙真 ZHANG Longzhen

机构地区：[1]漯河市中心医院,河南漯河462000

出　　处：《新中医》2023年第1期120-124,共5页New Chinese Medicine

摘　　要：目的:观察健脾清热解毒方联合常规疗法治疗小儿湿热瘀毒内阻型紫癜性肾炎(HSPN)的疗效。方法:选取50例湿热瘀毒内阻型HSPN患儿,按随机数字表法分为对照组及观察组各25例。对照组给予常规治疗,观察组在对照组基础上给予健脾清热解毒方,2组均治疗3个月。观察2组临床疗效及不良反应发生情况,比较2组治疗前后中医证候积分、肾功能指标[24 h尿蛋白含量、尿红细胞、肾损伤分子(KIM-1)、中性粒细胞明胶酶相关载脂蛋白(NGAL)]、免疫功能指标[免疫球蛋白A (IgA)、免疫球蛋白G (IgG)、免疫球蛋白M (IgM)、外周血增殖诱导配体(APRIL)、B淋巴细胞活化因子(BAFF)]值的变化。结果:观察组临床疗效总有效率为96.00%,对照组为68.00%,2组比较,差异有统计学意义(P<0.05)。治疗后,2组水肿、尿血、口苦口黏、口干、胸闷痞满、头身困重的中医证候积分均较治疗前下降(P<0.05),观察组上述6项积分均低于对照组(P<0.05)。治疗后,2组24 h尿蛋白含量、尿红细胞、KIM-1、NGAL指标值均较治疗前下降(P<0.05),观察组上述4项指标值均低于对照组(P<0.05)。治疗后,2组IgA、IgG、IgM、APRIL水平均较治疗前下降,BAFF水平均较治疗前上升,差异均有统计学意义(P<0.05);治疗后,观察组IgA、IgG、IgM、APRIL水平均低于对照组,BAFF水平高于对照组,差异均有统计学意义(P<0.05)。观察组不良反应发生率为4.00%,对照组为12.00%,2组比较,差异无统计学意义(P>0.05)。结论:健脾清热解毒方联合常规疗法治疗湿热瘀毒内阻型小儿HSPN可缓解患儿临床症状,改善肾功能指标及免疫紊乱状态,提高临床疗效。Objective:To observe the clinical effect of Jianpi Qingre Jiedu Prescription combined with routine therapy for henoch-schionlein purpura nephritis(HSPN) of internal obstruction of damp-heat,blood stasis and toxin type in children. Methods:A total of 50 cases of HSPN of internal obstruction of damp-heat blood stasis and toxin type were selected and divided into the control group and the observation group according to the random number table method,with 25 cases in each group. The control group was given routine therapy and the observation group was additionally treated with Jianpi Qingre Jiedu Prescription based on the treatment of the control group. Both groups were treated for three months. The clinical effects and incidence of adverse reactions in both groups were observed,and the changes of traditional Chinese(TCM) medicine syndrome scores, renal function indexes, including 24-hour urinary protein content, urine red blood cells, kidney injury molecule(KIM-1), and neutrophil gelatinase-associated lipocalin(NGAL), and the immune function indexes,including immunoglobulin A(lgA),immunoglobulin G(lgG),immunoglobulin M(lgM),a proliferation inducing ligand(APRIL),and B-cell activating factor of the TNF family(BAFF) were compared in both groups before and after treatment. Results:The total effective rate was 96.00% in the observation group,higher than that of 68.00% in the control group,the difference being significant(P<0.05). After treatment, the TCM syndrome scores of edema, bloody urine, bitter taste and sticky mouth,dry mouth,distress and fullness in the chest,and fatigue and heaviness of the head and body in both groups were decreased when compared with those before treatment,and the above six scores in the observation group were lower than those in the control group(P<0.05). After treatment,the indexes of 24-hour urinary protein content, urine red blood cells, KIM-1, and NGAL in the two groups were decreased when compared with those before treatment(P<0.05),and the above four indexes in the observation group we

关 键 词：紫癜性肾炎 小儿 湿热瘀毒内阻型 健脾清热解毒方 肾功能 

分 类 号：R269[医药卫生—中西医结合]