雷公藤联合丹参治疗对紫癜性肾炎患儿肾功能、凝血功能、免疫应答的影响

Effects of tripterygium wilfordii combined with Salvia Miltiorrhiza therapy on renal function,coagulation function and immune response in children with purpura nephritis

目的:探讨雷公藤联合丹参治疗对紫癜性肾炎患儿肾功能、凝血功能、免疫应答的影响。方法:2013年10月~2017年3月到本院就诊的紫癜性肾炎患儿70例,经随机数表法分为对照组、丹参组各35例。对照组接受常规+雷公藤治疗,丹参组接受常规+雷公藤+丹参治疗,持续3疗程。对比两组患者治疗前后肾功能、凝血功能、免疫应答的差异。结果:治疗前,两组肾功能、凝血功能、免疫应答功能的差异无统计学意义。治疗3疗程后,丹参组肾功能指标CysC、β2MG、24hUmAlb的水平低于对照组;外周血凝血功能指标FIB、D-D的水平低于对照组;外周血免疫应答指标Th1细胞因子IL-2、IFN-γ的含量高于对照组,Th2细胞因子IL-5、IL-10的含量低于对照组。结论:紫癜性肾炎患儿接受雷公藤联合丹参治疗可有效优化肾功能、降低机体高凝状态、减轻Th1/Th2免疫失衡程度。

Objective:To investigate the effects of tripterygium wilfordii combined with Salvia Miltiorrhiza therapy on renal function,coagulation function and immune response in children with purpura nephritis.Methods:70 children with purpura nephritis who were treated in the hospital between October 2013 and March 2017 were divided into control group(n=35)and Salvia Miltiorrhiza group(n=35)by random number table.Control group received routine+tripterygium wilfordii therapy,Salvia Miltiorrhiza group received routine+tripterygium wilfordii+ Salvia Miltiorrhiza therapy,and the therapies lasted for 3 courses.The differences in renal function,coagulation function and immune response were compared between the two groups before and after treatment.Results:Before treatment,there was no statistically significant difference in renal function,coagulation function and immune response function between the two groups.After 3 courses of treatment,renal function indexes CysC,β2 MG and 24 hUmAlb levels in Salvia Miltiorrhizagroup were lower than those in control group;coagulation function indexes FIB and D-D levels in peripheral blood were lower than those of control group;immune response indexes Th1 cytokines IL-2 and IFN-γcontents in peripheral blood were higher than those of control group whereas Th2 cytokines IL-5 and IL-10 contents were lower than those of control group.Conclusion:Tripterygium wilfordii combined with Salvia Miltiorrhiza therapy can effectively optimize the renal function,reduce the hypercoagulation state and reduce the Th1/Th2 immune imbalance in children with purpura nephritis.