肾病合剂配合激素对小儿复发性肾病的临床疗效及血、尿IL-6和TNF-α影响的研究

Clinical Effect of Shenbing Mistura Combined with Glucocorticoid on Recurrent Nephrotic Syndrome in Children and Levels of Interleukin-6 and Tumor Necrosis Factor-α in Blood and Urine

目的探讨中药肾病合剂配合激素对小儿复发性肾病(RNS)的临床疗效及血、尿白细胞介素-6(IL-6)和肿瘤坏死因子-α(TNF-α)的影响。方法将患者分为治疗组、对照组,并设健康组,各30例,治疗组采用肾病合剂配合激素治疗,对照组单纯用激素治疗;观察治疗前及治疗后4、8、12周血、尿中的IL-6和TNF-α浓度以及临床疗效和复发情况。结果血、尿IL-6和TNF-α含量治疗前后自身对照及两组间比较,差异均有显著性(P<0.01)。两组临床疗效比较差异有显著性(P<0.01)。随访18个月,治疗组复发率明显低于对照组(P<0.01)。结论肾病合剂配合激素能够减少小儿肾病复发,提高临床疗效,降低血、尿IL-6和TNF-α的水平。

Objective To study the effect of Shenbing Mistura （SM） combined with glucocorticoid on recurrent nephrotic syndrome （RNS） in children and levels of interleukin-6 （IL-6） and tumor necrosis factor-α （TNF-α） in blood and urine. Methods The treatment group was treated with SM plus glucocorticoid, the control group with glucocorticoid alone, and a healthy control group was adopted, 30 cases in each group. The clinical effect and recurrence rate were observed, and levels of IL-6 and TNF-α in blood and urine were determined before treatment and at the 4th, 8th, 12th week after treatment. Results Significant difference of IL-6 and TNF-α levels in blood and urine was found in either the pre- and post- treatment auto-control of both the treatment group and control group, or in the inter-group comparison of them （P〈0.01） ; clinical effect also showed remarkable difference between the two groups （P 〈 0.01 ）. Furthermore, the recurrence rate of the treatment group was lower than that of the control group showed by a 18-month follow-up （P〈0.01）. Conclusion SM combined with glucocorticoid could significantly reduce the recurrence rate and elevate the clinical effect in children with RNS, it could also lower the levels of IL-6 and TNF-α in patients＇ blood and urine.