雷公藤总甙治疗儿童难治性肾病综合征的研究  

Clinical observations on the effects of double doses of glucosides of TWH for nephrotic syndrome in children

作　　者：刘光陵[1] 高远赋[1] 夏正坤[1] 张连丰[1] 付元凤[1] 樊忠民[1] 伏洁[1] 

机构地区：[1]南京军区南京总医院南京军区儿科中心,江苏南京210002

出　　处：《医学研究生学报》2003年第7期518-520,共3页Journal of Medical Postgraduates

摘　　要：目的 :观察用双倍剂量雷公藤总甙治疗儿童难治性肾病综合征 (NS)的疗效。　方法 :对 1 998年 2月 2 0 0 2年 1 2月在该科住院且病理类型明确的 86例难治性NS患儿 ,用雷公藤总甙 2mg/ (kg·d)治疗 4周 ,随后减半量维持。　结果 :在治疗期间 ,6 6例患儿病情缓解 (占 76 .7% ) ,1 6例改善 (占 1 8.6 % ) ,4例无数 (占 4 .7% ) ,总有效率达95 .3%。其中微小病变型肾病综合征 (MCNS)、系膜增生性肾小球肾炎 (MsPGN)、膜增生性肾小球肾炎 (MPGN)和膜性肾病 (MN)的缓解率分别为 82 .1 % (2 3/ 2 8)、83.8% (31 / 37)、6 6 .7% (1 0 / 1 5 )和 33.3% (2 / 6 )。随访 3个月内未见复发。　结论Objectives: To evaluate the therapeutic effects of double doses of total glucosides of Tripterygium Wilfordii Hook F (TWH) on refractory nephrotic syndrome in children. Methods: During the last three years the glucosides of TWH were used in a dose of 2 mg/kg daily for 4 weeks to treat 86 consecutive children with refractory nephrotic syndrome confirmed by clinical examinations in our hospital. After 4 weeks, the half dose of the glucosides of TWH was used for maintenance. Results:During the treatment, 66 children achieved an entire remission(76.7%), 16 children achieved improvement. Four children had no effects. Overall effective rate was 95.3%. Among 66 cases of entire remission, the remission rate of MCNS, MsPGN, MPGN and MN were 82.1%(23/28),83.8%(31/37),66.7%(10/15),33.3% (2/6)respectively. Following three months observation no case relapse occurred. Conclusions: Therapeutic effects of the glucosides of TWH are greatly related to the different pathological type of this disease. When the cases are resistant to steroids, renal biopsy should be performed to established the pathological diagnosis. Double doses of the glucosides of TWH is one of effective therapeutics for the refractory nephrotic syndrome. It can be applied alone to treat the cases of MCNS, MsPGN and MPGN, in order to avoiding side reactions from prolonged administration of steroids.

关 键 词：雷公藤总甙 双倍剂量 儿童 难治性肾病综合征 

分 类 号：R282.71[医药卫生—中药学]