中西医结合治疗小儿原发性肾病综合征40例临床观察

Integrating traditional Chinese medicine and western medicine in the treatment of child primary nephrotic syndrome:a clinical study of 40 cases

目的:观察激素配合加减桂枝茯苓汤治疗小儿原发性肾病综合征的临床疗效。方法:将80例患者随机分为2组,各40例,对照组采用激素标准中长程治疗,治疗组在激素治疗的基础上配合加减桂枝茯苓汤治疗。观察治疗后和6个月随访时血浆蛋白定量、24 h尿蛋白定量、血胆固醇、临床疗效、治疗性副作用等情况。结果:临床总有效率治疗组为92.5%(37/40),对照组为75.0%(30/40),两组比较,差异有统计学意义(P<0.05)。治疗前、后两组患儿血胆固醇水平分别是(6.78±0.65)mmol/L、(6.64±0.44)mmol/L和(3.24±0.18)mmol/L、(4.58±0.12)mmol/L,24 h尿蛋白定量分别是(6.28±3.86)g/24h、(6.48±3.27)g/24h和(0.25±0.17)g/24h、(0.98±0.22)g/24h,血浆蛋白定量分别是(20.23±3.56)g/L、(21.32±3.21)g/L和(45.18±16.56)g/L、(35.28±12.33)g/L,治疗后两组患儿血胆固醇水平、24 h尿蛋白定量、血浆蛋白定量较治疗前均有明显改善,两组比较差异均有统计学意义(P均<0.05)。治疗性副作用发生率治疗组为22.5%(9/40),对照组为47.5%(19/40),治疗组明显低于对照组,差异有统计学意义(P<0.05)。6个月随访时临床有效率治疗组为77.5%,对照组为45.0%,两组比较,差异有统计学意义(P<0.05)。结论:规范激素治疗配合加减桂枝茯苓汤治疗小儿原发性肾病综合征能有效减少24 h尿蛋白定量、提高血浆白蛋白水平,降低血胆固醇,减少治疗性副作用,提高临床治疗效果。

Objective：To obverse the clinical effect of hormone and Jiajian Guizhi Fuling soup in the treatment of child primary nephrotic syndrome.Methods：80 patients were randomly divided into two groups,with 40 cases in each group.The control group was administrated mid-and-long term standard treatment with hormone;and the treatment group was given Jiajian Guizhi Fuling soup besides the same treatment as control group.To observe the changes of blood protein quantity,24 hours urinary protein quantity,blood cholesterol level,clinical efficacy and side effects in two groups after treatment and the follow-up investigation after 6 months.Results：The total effective rate of treatment group and control group reached 92.5%（37/40） and 75.0%（30/40） respectively after treatment（P0.05）.The levels of blood cholesterol,24 hours urinary protein quantity（UTP）nd,blood protein quantity level in two groups were significantly more improved than those before treatment [The levels of blood cholesterol（6.78±0.65） mmol/L,（6.64±0.44） mmol/L vs（3.24±0.18） mmol/L,（4.58±0.12） mmol/L,P0.05;UTP（6.28±3.86） g/24h,（6.48±3.27） g/24h vs（0.25±0.17） g/24h,（0.98±0.22） g/24h,P0.05;Blood protein quantity level（20.23±3.56） g/L,（21.32±3.21） g/L vs（45.18±16.56） g/L,（35.28±12.33） g/L,P0.05].The incidence of side effects during treatment in treatment group was 22.5%（9/40）and 47.5%（19/40）in control group（P0.05）.The total effective rate with follow-up investigation after 6 months reached 77.5% in treatment group and 45.0% in control group（P0.05）.Conclusion：On the basis of hormone,the combining use of Jiajian Guizhi Fuling soup were effective in treating child primary nephrotic syndrome in decreasing 24 hours urinary protein quantity,increasing the plasma albumin,lowering serum cholesterol,reducing the side effect of treatment and improving the clinical therapy effect.