补肾活血汤辅助泼尼松对原发性肾病综合征儿童眼部不良反应、视盘结构参数、复发的影响  

Effect of Bushen Huoxue Decoction(补肾活血汤)Supplemented with Prednisone on Ocular Adverse Reactions,Optic Disc Structure Parameters and Recurrence in Children with Primary Nephrotic Syndrome

作　　者：曹广海 魏磊[1] 刘玉洁[1] 田明 张书锋[1] 刘平[1] 刘翠华[1] CAO Guanghai;WEI Lei;LIU Yujie;TIAN Ming;ZHANG Shufeng;LIU Ping;LIU Cuihua(Children's Hospital Affiliated to Zhengzhou University,Henan children's Hospital,Zhengzhou children's Hospital,Zhengzhou 450018,Henan,China)

机构地区：[1]郑州大学附属儿童医院,河南省儿童医院,郑州儿童医院,河南郑州450018

出　　处：《中华中医药学刊》2023年第9期140-143,共4页Chinese Archives of Traditional Chinese Medicine

基　　金：国家中医药管理局中医药科学技术研究专项(2019ZX5235691763);河南省卫生和计划生育委员会、河南省医学科技攻关计划(联合共建)项目(2018020672)。

摘　　要：目的探讨补肾活血汤辅助泼尼松对原发性肾病综合征儿童眼部不良反应、视盘结构参数、复发的影响。方法选择2019年1月—2021年1月120例确诊为原发性肾病综合征的儿童作为研究对象,采用随机数字法平均分为观察组与对照组:对照组给予泼尼松治疗,观察组在对照组基础上辅以补肾活血汤治疗。比例两组患儿出现眼部不良反应情况、视盘结构参数及复发情况。结果观察组复发次数、泼尼松用量均较对照组少(P<0.05);但随访12月时两组完全缓解及部分缓解比较差异无统计学意义(P>0.05)。观察组总眼部不良反应及单纯性白内障发生率均低于对照组(P<0.05),单纯性高眼压、高眼压联合白内障发生率比较差异无统计学意义(P>0.05)。两组患儿泼尼松治疗后眼压开始升高,治疗后3月眼压达高峰,后逐渐降低,但仍高于治疗前(P<0.05),观察组治疗后3、6、12月眼压均高于对照组(P<0.05);两组患儿泼尼松治疗后屈光度开始逐渐减小(P<0.05),观察组治疗后3、6、12月屈光度均低于对照组(P<0.05)。两组患儿泼尼松治疗后杯/盘比逐渐增高,盘沿体积、盘沿面积、神经纤维层平均厚度、神经纤维横截面面积均逐渐降低(P<0.05),而最大视杯深度变化差异无统计学意义(P>0.05);观察组治疗后3、6、12月杯/盘比低于对照组同时期(P<0.05),而盘沿体积、盘沿面积、神经纤维层平均厚度、神经纤维横截面面积均高于对照组同时期(P<0.05)。结论补肾活血汤辅助泼尼松可以更好地降低PNS患儿复发次数及激素剂量,且对降低糖皮质激素型高眼压监测、控制白内障病情进展有积极的作用。Objective To investigate the effect of Bushen Huoxue Decoction(补肾活血汤)supplemented with prednisone on ocular adverse reactions,optic disc structure parameters and recurrence in children with primary nephrotic syndrome.Methods A total of 120 children diagnosed as primary nephrotic syndrome from January 2019 to January 2021 were selected as the research subjects,and they were equally divided into the observation group and the control group by the random number method.The con-trol group was given prednisone,and the observation group was additionally given Bushen Huoxue Decoction on the basis of the control group.The proportion of children in the two groups experienced adverse ocular reactions,optic disc structure parameters and recurrence.Results Recurrence times and prednisone dosage in the observation group were less than those in the control group(P<0.05).However,there was no difference in total or partial response between the two groups after 12-month follow-up(P>0.05).The incidences of total ocular adverse reactions and simple glaucoma in the observation group were lower than those in the control group(P<0.05),and there was no difference in the incidences of simple cataract or glaucoma combined with cataract(P>0.05).The intraocular pressure of children in the two groups began to increase after prednisone treatment,and peaked at 3 months after treatment and then gradually decreased,but it was still higher than that before treatment(P<0.05).The intraocular pressure in the observation group was higher than that in the control group at 3,6 and 12 months after treatment(P<0.05).The diopters of children in the two groups gradually decreased after treatment with prednisone(P<0.05).The di-opters of children in the observation group were lower than those in the control group at 3,6 and 12 months after treatment(P<0.05).After treatment with prednisone,the cup/plate ratio was gradually increased,and the rim volume,rim area,average thick-ness of nerve fiber layer and cross-sectional area of nerve fibers were all g

关 键 词：补肾活血汤 泼尼松 原发性肾病综合征 儿童 眼部 不良反应 

分 类 号：R256.5[医药卫生—中医内科学]