加味防己黄芪汤联合激素治疗对小儿原发性肾病综合征肾功能、血脂及血凝状态的影响

Effects of Jiawei Fangji Huangqi Decoction Combined with Hormonotherapy on Renal Function,Blood Lipid and Blood Coagulation Status in Child Patients with Primary Nephrotic Syndrome

目的:探讨加味防己黄芪汤联合激素治疗对小儿原发性肾病综合征(PNS)肾功能、血脂及血凝状态的影响。方法:选取2017年2月至2018年3月琼海市中医院收治的小儿PNS患者共106例作为研究对象,随机分为观察组和对照组,每组53例。对照组在常规治疗的基础上给予泼尼松治疗;观察组在对照组的基础上给予加味防己黄芪汤治疗,比较2组患者治疗前后血凝状态和血小板聚集率、血脂、肾功能以及临床疗效方面的差别。结果:观察组总有效率为92. 45%,对照组的总有效率为81. 13%,观察组高于对照组,差异有统计学意义(P <0. 05)。与治疗前比较,2组患者的血胆固醇(TC)、三酰甘油(TG)、尿素氮(BUN)、24尿蛋白定量(24 h Upr)、血肌酐(SCr)、血浆黏度(PV)、血尿酸(NA)和血小板聚集率水平均降低(P <0. 05),且观察组比对照组降低更明显,差异有统计学意义(P <0. 05)。治疗后,2组患者的凝血酶原时间(PT)和血清白蛋白(ALB)均升高(P <0. 05),且观察组高于对照组,差异有统计学意义(P <0. 05)。结论:针对PNS患儿应用加味防己黄芪汤联合激素治疗,能降糖降脂,改变血液高凝状态,改善肾脏生理功能,对小儿PNS疗效显著,值得临床推广应用。

Objective: To evaluate the effects on blood lipid,renal function and blood coagulation status in child patients with primary nephrotic syndrome (PNS) using Jiawei Fangji Huangqi Decoction combined with hormonotherapy. Methods: A total of 106 child patients with PNS in Qionghai Hospital of Traditional Chinese Medicine from February 2017 to March 2018 were randomly divided into the observation group and the control group.On the basis of conventional therapy,53 patients in the control group were treated with prednisone only,and 53 patients in the observation group were treated with Jiawei Fangji Huangqi Decoction on the basis of the control group.The levels of blood lipids (TG and TC),blood coagulation status (PV,PT,ALB and platelet aggregation rate),renal function (24UPr,BUN,SCr and NA) and total effective rate were compared between the 2 groups. Results: The total effective rate was 92.45% in the observation group,which was higher than 81.13% in the control group,with significant difference ( P <0.05).After treatment,the levels of TG,TC,24UPr,BUN,SCr,NA,PV and platelet aggregation rate in both groups were decreased ( P <0.05),and the decrease was more significant in the observation group than in the control group,with significant difference ( P <0.05).The levels of PT and ALB of the 2 groups was increased after treatment,and the increase was more significant in the control group than in the observation group ( P <0.05). Conclusion: The Jiawei Fangji Huangqi Decoction combined with hormonotherapy in the treatment of child patients with PNS can reduce the blood lipid,improve blood hypercoagulability and improve renal physiological function.It has a very significant clinical effect in child patients with PNS and can be widely used and applied.