中西医结合治疗小儿难治性肾病综合征的疗效观察

Observation on curative effects on treatment for child refractory nephropathy syndrome with integrated traditional Chinese and western medicine

目的：观察中西医结合治疗小儿难治性肾病综合征的临床疗效。方法：治疗组４０例患儿采用泼尼松、肝素及中药相结合治疗；对照组３６例只用与治疗组相同西药治疗；检测患儿治疗前后尿蛋白，血胆固醇、尿素氮及血、尿中纤维蛋白降解产物（ＦＤＰ）含量变化。结果：２组治疗后各项检测指标显著降低，治疗组尿蛋白、血尿素氮较对照组降低有极显著性差异（Ｐ均＜０．００１）。２组近期疗效比较，治疗组、对照组完全缓解率分别为８５．０％和８３．３％，无显著性差异（χ２＝２．１７，Ｐ＞０．０５）；远期疗效显示，治疗组、对照组复发率分别为１５．４％和４１．２％，有显著性差异（χ２＝６．５３，Ｐ＜０．０５）。结论：中西医结合治疗小儿难治性肾病综合征疗效显著，有助于消除肾病本身及长期激素治疗加重的血液高凝状态，增强病情稳定性，减少复发。

Objective :To observe the clinically curative effects of integrated traditional Chinese and western medicine (TCM WM) therapy on child refractory nephropathy syndrome. Methods :Prednisone and heparin combined with traditional Chinese medicine were used in treatment group and the same western medicine was used in control group.Urinary proteins,blood cholesterol,blood urea nitrogen (BUN),and fibrinogen degradation product(FDP) were measured before and after therapy. Results :After therapy all of the parameters measured were depressed in two groups and the urinary proteins and BUN were significantly decreased in treatment group than those in control group (both P<0001),meantime in comparison for short term curative effects the complete remission rates were 850% in treatment group and 833% in control group respectively and the difference was not significant (2=217,P>005).The long term curative effects showed that the recurrence rates were 154% in treatment group and 412% in control group respectively and the difference was significant (2=653,P<005). Conclusions :The curative effects of integrated TCM WM therapy on child refractory nephropathy syndrome are obvious,which is helpful to eliminate the conditions of high blood coagulation induced by nephropathy per se and steroid therapy,to enhance the stability of disease,and to decrease the recurrence.