ISSN 1674-3865  CN 21-1569/R
主管:国家卫生健康委员会
主办:中国医师协会
   辽宁省基础医学研究所
   辽宁中医药大学附属医院

中国中西医结合儿科学 ›› 2019, Vol. 11 ›› Issue (3): 206-209.doi: 10.3969/j.issn.1674-3865.2019.03.007

• 临床论著 • 上一篇    下一篇

益气化瘀清热方治疗小儿难治性肾病临床观察

张秋月,翟文生,刘翠华,张霞,杨濛,张建,郭庆寅,宋纯东#br#   

  1. 450000郑州,河南中医药大学第一附属医院儿科(张秋月,翟文生,张霞,杨濛,张建,郭庆寅,宋纯东);450000郑州,郑州市儿童医院肾内科(刘翠华)
  • 出版日期:2019-06-25 发布日期:2019-07-04
  • 通讯作者: 翟文生,E-mail:zhws65415@sina.com
  • 作者简介:张秋月(1989-),女,医学硕士。研究方向:小儿肾脏病的诊治
  • 基金资助:
    国家自然科学基金项目(81273803);河南中医管理局项目(2017zy1011);河南省特色学科建设项目(STS-ZYX2017007)

Observation on the efficacy of Yiqi Huayu Qingre prescription in the treatment of children with refractory nephritic syndrome

ZHANG Qiuyue,ZHAI Wensheng,LIU Cuihua,ZHANG Xia,YANG Meng,ZHANG Jian,GUO Qingyin,SONG Chundong.   

  1. Pediatric Department of the First Affiliated Hospital of Henan University of Traditional Chinese Medicine, Zhengzhou 450000,China
  • Online:2019-06-25 Published:2019-07-04

摘要: 目的观察益气化瘀清热方治疗儿童难治性肾病综合征临床疗效。
方法2013年7月至2014年7月河南中医学院第一附属医院和郑州市儿童医院收治门诊和住院的难治性肾病综合征患儿60例,随机分为对照组和观察组各30例。对照组常规给予抗感染、抗凝、利尿等对症治疗,应用足量强的松(2 mg/kg)诱导缓解。观察组在对照组治疗基础上加用益气化瘀清热方加减,4周为1个疗程,共9个疗程。观察临床疗效及复发率;疗效指标:24 h尿蛋白定量、血浆白蛋白、血总胆固醇、活化部分凝血酶时间、凝血酶原时间、纤维蛋白原;安全性指标:不良反应的症状及体征,血常规,肝功能及肾功能检查。
结果观察组临床总有效率为86.7%(26/30),优于对照组70.0%(21/30),差异有统计学意义(P<0.05)。治疗后观察组复发率为36.7%(11/30),显著低于对照组70.0%(21/30),差异有统计学意义(P<0.05)。观察组治疗后血白蛋白、活化部分凝血酶时间、凝血酶原时间高于治疗前,24 h蛋白定量、总胆固醇、纤维蛋白原低于治疗前,差异有统计学意义(P<0.05);且观察组在改善以上指标方面优于对照组,差异有统计学意义(P<0.05)。两组治疗前后血常规、谷丙转氨酶、谷草转氨酶、尿素氮和血肌酐方面比较差异无统计学意义(P>0.05),并未发现严重不良反应。
结论益气化瘀清热方可改善患儿24 h蛋白定量、血浆白蛋白、血脂及高凝血情况,减少儿童难治性肾病综合征的复发率,提高临床总有效率,临床观察未见不良反应。

关键词: 难治性肾病, 益气化瘀清热方, 儿童

Abstract: Objective
To observe the clinical effects of Yiqi Huayu Qingre prescription on refractory nephrotic syndrome(RNS) in children.
Methods
A total of 60 cases of RNS enrolled from July 2013 to July 2014 in the First Affiliated Hospital of Henan University of Traditional Chinese Medicine and Children's Hospital of Zhengzhou city were randomly divided into control group(30 cases) and observation group(30 cases). The children were routinely symptomatic treatment in the control group, such as anti-infection, anticoagulation and diuresis, and sufficient prednisone was given(2 mg/kg) to induce remission. The observation group was treated with Yiqi Huayu Qingre prescription on the basis of the treatment for control group, 4 weeks as a course of treatment, for a total of 9 courses. Observe the clinical efficacy and recurrence rate; efficacy indicators:24hUTP,ALB,CHOL,FIB,PT,APT;safety indicators: symptoms and signs of adverse reactions, blood routine examination and hepatorenal function.
Results
The total clinical effective rate of the observation group was 86.7%(26/30), which was better than that of the control group(70.0%,21/30), the difference being statistically significant(P<0.05).After treatment, the recurrence rate in the observation group was 36.7%(11/30), which was significantly lower than that in the control group(70.0%,21/30), the difference being statistically significant(P<0.05). After treatment, the serum albumin, activated partial thrombin time and prothrombin time in the observation group were higher than those before treatment, while 24h protein quantity, total cholesterol and fibrinogen in the observation group were significantly lower, the difference being statistically significant(P<0.05); the observation group was better than the control group in the improvement of the above indexes, the difference being statistically significant(P<0.05). There was no significant difference in such indexes as blood routine, glutamicpyruvic transaminase, glutamicoxaloacetic transaminase, urea nitrogen or serum creatinine between the two groups before and after treatment(P>0.05), and no serious adverse reactions were found.
Conclusion
Yiqi Huayu Qingre prescription can improve the indexes including 24h protein quantity, plasma albumin, blood lipid and hypercoagulability in children, reduce the recurrence rate of refractory nephrotic syndrome in children, and improve the total clinical effective rate. There are no adverse reactions in the clinical observations.

Key words: Refractory nephritic syndrome, Yiqi Huayu Qingre prescription, Children