保肾消浊汤联合吗替麦考酚酯治疗儿童难治性肾病综合征的疗效

Efficacy of Baoshen Xiaoshi decoction combined with mycophenolate mofetil in children with refractory nephrotic syndrome

目的探讨保肾消浊汤联合吗替麦考酚酯对儿童难治性肾病综合征的治疗效果。方法将102例难治性肾病综合征患儿随机分为2组,每组51例。对照组给予吗替麦考酚酯,观察组在对照组的基础上给予保肾消浊汤。治疗6个月,对2组肾功能指标(Upro、BUN、Scr、TC、TG、Alb)、血流变指标(血栓素B2、6-酮-前列腺素)、肝功能指标(ALT、AST)及疗效进行观察。结果治疗后,2组Upro、BUN、Scr、TC水平显著降低(P<0.05),观察组Upro、Scr、TC水平显著低于对照组(P<0.05),2组BUN差异无统计学意义(P>0.05);治疗前后2组TG水平无明显变化(P>0.05);治疗后,2组Alb水平显著升高(P<0.05),2组Alb水平差异无统计学意义(P>0.05)。治疗后,2组血栓素B2显著降低,且观察组血栓素B2显著低于对照组(P<0.05);治疗后,2组6-酮-前列腺素显著升高,且观察组6-酮-前列腺素显著大于对照组(P<0.05)。治疗前后2组ALT、AST水平变化无统计学意义(P>0.05);观察组治疗总缓解率为88.2%,显著性高于对照组的72.5%(P<0.05)。结论保肾消浊汤联合吗替麦考酚酯可有效地改善患者的肾功能指标,纠正患者高凝状态,并对肝脏有保护作用。

Objective To investigate the efficacy of Baoshen Xiaoshi decoction combined with mycophenolate mofetil in children with refractory nephrotic syndrome. Methods A total of 102 children with refractory nephrotic syndrome were randomly divided into two groups with 51 cases in each group. The patients in control group were given mycophenolate mofetil, and patients in observation group were given Baoshen Xiaoshi decoction based on control group. After a six months treatment, the renal function indicators levels （ Upro, BUN, Scr, TC, TG and Alb）, blood flow indicators （ thromboxane B2, 6-keto-prostaglandin） ,liver function indicators levels （ALT, AST） and clinical efficacy of two groups were comapred. Re- sults After the treatment,Upro,BUN,Scr and TC levels of both groups were significantly reduced（P 〈0.05） ,Upro,Scr and TC levels of the observation group were significantly lower than that in the control group（ P 〈 0.05 ）, but BUN levels of both groups had no significant difference （ P 〉 0.05 ） ; Before and after the treatment,TG levels of two groups had no sig- nificant change （ P 〉 0.05 ） ; After the treatment, Alb levels of both groups were significantly increased （ P 〈 0.05 ）, but Alb levels of both groups had no significant difference（ P 〉 0.05 ）. After the treatment, thromboxane B2 levels of both groups were significantly reduced（ P 〈 0.05 ）, thromboxane B2 level of the observation group was significantly lower than that of the control group（P 〈 0.05 ） ;after the treatment,6-keto-prostaglandin levels of both groups were significantly increased （P 〈 0.05 ） ,6-keto-prostaglandin level of the observation group was significantlyhigher than that of the control group（ P 〈 0.05）. Before and after the treatment, ALT and AST levels of both groups had no significantly change （ P 〉 0.05 ）. The therapy overall relief rate of the observation group was 88.2% ,which was significant higher than 72.5% in the control group,P 〈 0.05. Conclusion Baoshen Xiaoshi decoction combined with mycophenolate mofetil can effectively improve the renal function and protect the liver of children with refractory nephrotic syndrome.