RNS患儿激素治疗不同阶段中医证型分布探析

Analysis on the Distribution of TCM Syndromes in Different Stages of Hormone Therapy in Children with RNS

目的:分析儿童难治性肾病综合征使用激素期间及停用激素中医证型分布及变化规律。方法:RNS患儿的临床资料进行回顾性分析,观察RNS患儿应用激素期间及停用激素中医证型的变化。结果:RNS患儿在激素诱导、巩固维持阶段及停用激素中医证型以虚实夹杂证为主。本虚证方面,诱导阶段以阴虚火旺证(79.2%)为主;巩固维持阶段以气阴两虚证(62.2%)为主;停用激素以肺脾气虚证(46.6%)、脾肾阳虚证(36.2%)为主。标实证方面,诱导阶段以湿热证(72.9%)为主;巩固维持阶段以水湿证(39.8%)、血瘀证(31.8%)为主;停用激素以外感证(51.7%)为主。结论:RNS患儿在激素诱导、巩固维持阶段及停用激素本虚证、标实证呈现动态变化。本虚证由阴虚火旺证→气阴两虚证→肺脾气虚证、脾肾阳虚证变化。标实证由湿热证→水湿证、血瘀证→外感证变化。

Objective： To analyze the distribution and variation of TCM syndromes of refractory nephrotic syndrome in children during hormone use and hormone withdrawal. Methods： RNS with clinical data were retrospectively ana- lyzed, observing RNS children using hormones during hormone changes of TCM syndrome type and the substance is discontinued. Results： The syndrome types of traditional Chinese medicine （ TCM ） in children with RNS during hor- mone induction, consolidation and maintenance and hormone withdrawal were mainly mixed with deficiency and real- ity. In the aspect of deficiency syndrome, the hormone induction stage was dominated by Yin deficiency and fire pros- perity syndrome （ 79.2% ）. Hormone consolidation and maintenance stage, mainly Qi Yin two deficiency syndrome （ 62.2% ） ; Hormone withdrawal was mainly caused by lung and spleen Qi deficiency syndrome （ 46.6% ） and spleen and kidney Yang deficiency syndrome （ 36.2% ）. In the aspect of excess syndrome, the hormone induction stage was mainly wet and hot syndrome （ 72.9% ）. During the hormone consolidation and maintenance stage, water-dampness syndrome （ 39.8% ） and blood stasis syndrome （ 31.8% ） were the main ones. Hormone withdrawal syndrome （ 51.7% ） was the main reason. Conclusion： there is a dynamic change of this deficiency syndrome and standard evidence in children with RNS after hormone induction, consolidation and maintenance and hormone withdrawal. This deficiency syndrome is caused by Yin deficiency and fire prosperity syndrome, Qi Yin two deficiency syndrome, lung and spleen Qi deficiency syndrome and spleen and kidney Yang deficiency syndrome. The syndrome was changed from damp heat syndrome to water damp syndrome, blood stasis syndrome to exogenous syndrome.