尿血1号方治疗儿童血热夹瘀型过敏性紫癜肾炎的临床疗效  

Clinical Efficacy of Niaoxue No.1 Prescription in Treatment of Henoch-Schönlein Purpura Nephritis with Blood Heat and Stasis Syndrome in Children

作　　者：郑珊[1,2] 文仲渝[2] 秦耘 刘毅[4] 袁超 李家熙 罗磊 张钰英 常克 ZHENG Shan;WEN Zhongyu;QIN Yun;LIU Yi;YUAN Chao;LI Jiaxi;LUO Lei;ZHANG Yuying;CHANG Ke(Chengdu University of Traditional Chinese Medicine(TCM),Chengdu 610075,China;Chongqing TCM Hospital,Chongqing 400021,China;Jiangbei District Hospital of TCM,Chongqing 400020,China;Qijiang District Hospital of TCM,Chongqing 401420,China)

机构地区：[1]成都中医药大学,成都610075 [2]重庆市中医院,重庆400021 [3]重庆市江北区中医院,重庆400020 [4]重庆市綦江区中医院,重庆401420

出　　处：《中国实验方剂学杂志》2023年第18期87-94,共8页Chinese Journal of Experimental Traditional Medical Formulae

基　　金：重庆市科委与卫生健康委联合医学科研项目(2022MSXM205);重庆市科研机构绩效激励引导专项(jxyn2021-1-6)。

摘　　要：目的:探讨尿血1号方治疗血热夹瘀证过敏性紫癜肾炎的临床疗效及对尿红细胞、尿蛋白、血中性粒细胞和血常规衍生指标的影响。方法:采用多中心,随机对照试验方法,将3家医院108例过敏性紫癜肾炎患儿,随机数字表法分为对照组和观察组,每组各54例。观察组予尿血1号方治疗,每日1剂;对照组予卡托普利及阿魏酸片治疗。两组疗程均为4周。监测尿镜检红细胞、尿微量白蛋白、尿沉渣红细胞计数、中医证候积分、24 h尿蛋白、血中性粒细胞比率、中性粒细胞/淋巴细胞(NLR)、血小板/淋巴细胞比值(PLR)、淋巴细胞/单核细胞比值(LMR)、D-二聚体、免疫球蛋白A(IgA),随访6个月后紫癜肾炎复发率。结果:观察组疾病总有效率为88.9%(48/54),对照组为70.4%(38/54),观察组优于对照组,差异具有统计学意义(χ^(2)=5.708,P<0.05)。与本组治疗前比较,治疗第14天,观察组患儿中医证候总积分、尿镜检红细胞、尿微量白蛋白、24 h尿蛋白均明显降低(P<0.05,P<0.01),与对照组治疗后比较,观察组中医证候总积分、尿镜检红细胞、尿微量白蛋白、24 h尿蛋白改善更明显(P<0.05)。与本组治疗前比较,治疗第28天,两组患儿中医证候积分、尿镜检红细胞、尿微量白蛋白、尿沉渣红细胞计数、D-二聚体及24 h尿蛋白均明显降低(P<0.05,P<0.01),与对照组治疗后比较,其中观察组尿微量白蛋白明显降低(P<0.05)。观察组在第14天和第28天时,中性粒细胞比率、NLR均低于对照组(P<0.05),但PLR、LMR差异无统计学意义。随访6个月后两组患儿肾炎复发率差异无统计学意义。结论:采用尿血1号方治疗血热夹瘀型紫癜肾炎,可显著改善临床症状,缩短病程。降低紫癜肾炎患儿尿红细胞、尿微量白蛋白、24 h尿蛋白、中性粒细胞及NLR,有效减轻肾脏的炎症状态,减轻肾脏损伤。Objective:To investigate the clinical efficacy of Niaoxue No.1 Prescription in treatingHenoch-Schönlein purpura(HSP)nephritis with blood heat and stasis syndrome and its effect on urine erythrocyte,urine protein,blood neutrophils,and blood routine-derived indicators.Method:A multicenter,randomized controlled trial(RCT)was conducted involving 108 HSP nephritis patients from three hospitals.The patients were randomly divided into a control group(54 cases)and a treatment group(54 cases).The treatment group received Niaoxue No.1 prescription once daily,while the control group was treated with captopril and ferulic acid tablets.Both groups underwent a 4-week course of treatment.The urine erythrocyte,urine microalbumin(mAlb),urine sediment red blood cell count,traditional Chinese medicine(TCM)syndrome score,24-hour urine protein,blood neutrophil count,neutrophil to lymphocyte ratio(NLR),platelet to lymphocyte ratio(PLR),lymphocyte to monocyte ratio(LMR),D-dimer,and immunoglobulin A were detected.The recurrence rate of HSP nephritis was followed up for 6 months.Result:The total effective rates were 88.9%(48/54)in the treatment group and 70.4%(38/54)in the control group,and the treatment group was superior to the control group(χ^(2)=5.708,P<0.05).Compared with the results before treatment,after 14 days of treatment,the TCM syndrome total score,urine erythrocyte,urine mAlb,and 24-hour urine protein in both groups significantly decreased(P<0.05,P<0.01),and the improvement was more significant in the treatment group than the control group(P<0.05).After 28 days of treatment,compared with the results before treatment,the TCM syndrome total score,urine erythrocyte,urine mAlb,urine sediment red blood cell count,D-dimer,and 24-hour urine protein in both groups significantly decreased(P<0.05,P<0.01),with the treatment group showing a more significant reduction in urine mAlb than the control group(P<0.05).On the 14th and 28th days of treatment,the neutrophil percentage and NLR were lower in the treatment group than in the contro

关 键 词：过敏性紫癜 肾炎 中性粒细胞 血热夹瘀证 

分 类 号：R2-0[医药卫生—中医学] R22R285.5R2-031R259R692.34