温阳利水化瘀方治疗儿童原发性难治性肾病综合征的临床研究

Clinical Study of Primary Refractory Nephrotic Syndrome in Children Treated by Wenyang Lishui Huayu Therapy

目的:探讨温阳利水化瘀法治疗儿童原发性难治性肾病综合征的临床疗效。方法:选取符合纳入标准的儿童难治性肾病综合征的患儿,共68例。按照随机数表法随机分为研究组和对照组各34例。其中,研究组采用糖皮质激素加温阳利水化瘀方治疗,对照组采用糖皮质激素加利尿剂治疗,连续治疗4周。观察两组患儿治疗前后的尿量、水肿情况,定期监测肾功能以及凝血指标;随访6个月,观察两组患儿病情复发情况以及感染情况,监测血白蛋白、肾小管功能指标。结果:治疗后,所有患儿的临床症状如尿量、水肿情况均明显缓解;同时,各项指标如尿素、血肌酐、尿NAG酶、尿β2微球蛋白、白蛋白、纤维蛋白原、D-二聚体有明显好转。研究组治疗2周、4周后的临床指标均优于对照组,差异有统计学意义(P<0.05)。研究组的临床疗效显著高于对照组,差异有统计学意义(P<0.05)。随访期间研究组复发率显著低于对照组(14.7%vs29.4%),差异有统计学意义(P<0.05)。随访期间研究组呼吸道感染率低于对照组(67.6%vs94.1%),且研究组患儿的各项实验室指标均明显优于对照组,差异有统计学意义(P<0.05)。结论:温阳利水化瘀方联合糖皮质激素治疗儿童难治性肾病综合征,临床疗效显著,值得在临床推广。

Objective:To explore the clinical efficacy of Wenyang Lishui Huayu therapy(therapy of strengthening yang to increase urine excretion and resolving blood stasis)in the treatment of primary refractory nephrotic syndrome in children.Methods:A total of 68 cases met the inclusion criteria were randomly divided into the study group(n=34)and the control group(n=34).The study group was treated with Glucocorticoid and Wenyang Lishi Huayu therapy,and the control group was treated with Glucocorticoid and diuretic drugs.The treatment duration was four weeks.The urine volume and edema alleviation were observed in the two groups.The renal function and coagulation index were monitored regularly.After 6 months of follow-up,the recurrence and infection were observed and the serum albumin and renal tubular function were monitored.Results:The clinical symptoms,such as urine volume and edema,were significantly relieved in the two groups;A variety of indicators,such as urea,serum creatinine,urinary NAGase,urineβ2 microglobulin,albumin,fibrinogen and D-dimer,were improved significantly after the treatment.The clinical indicators after 2 weeks and 4 weeks of treatment were better in the study group than those in the control group(P<0.05).The clinical efficacy of the study group was significantly higher than that of the control group(P<0.05).The recurrence rate wsa 14.7%in the study group,which was significantly lower than 29.4%in the control group(P<0.05).During the follow-up period,the respiratory infection rate 67.6%in the study group,which was greatly lower than 94.1%in the control group(P<0.05).Conclusion:Wenyang Lishui Huayu therapy combined with Glucocorticoids has remarkable clinical effect in the treatment of primary refractory nephrotic syndrome in children,which is worthy of clinical promotion.