防己黄芪汤合越婢汤加减联合西药治疗小儿肾病综合征的临床效果观察

Clinical Observation of Fangji Huangqi Decoction and Yuebi Decoction Plus Western Medicine on Nephrotic Syndrome in Children

目的:探讨防己黄芪汤合越婢汤加减联合西药治疗小儿肾病综合征(肺肾气虚、风水泛滥证)的临床效果。方法:选择2018年1月~2019年3月在我院就诊的114例肾病综合征患儿作为研究对象,采用随机数字表法将患者分为对照组和观察组各57例。对照组给予西药治疗,观察组在对照组的基础上给予防己黄芪汤合越婢汤加减治疗。观察两组患儿治疗前后血白蛋白(Alb)、T细胞亚群、24 h尿蛋白、总胆固醇(TC)、血肌酐、视黄醇结合蛋白(RBP)和胆碱酯酶(CHE),统计两组患儿的临床疗效和不良反应发生率。结果:治疗后两组患者Alb高于治疗前,24 h尿蛋白、TC、肌酐均低于治疗前,且观察组上述指标改善程度均高于对照组,差异均有统计学意义(P<0.05)。治疗后两组CD+4T细胞、CD+4/CD+8T细胞比值平与治疗前比较均显著升高(P<0.05),且观察组与同期对照组比较均显著升高(P<0.05);治疗后两组RBP、CHE水平与治疗前比较均显著降低(P<0.05),且观察组均显著低于对照组(P<0.05)。观察组临床有效率显著高于对照组,差异有统计学意义(P<0.05)。两组患儿治疗过程中未见明显不良反应。结论:防己黄芪汤合越婢汤联合西药治疗肺肾气虚、风水泛滥型小儿肾病综合征可改善实验室指标,提高临床效果,缓解RBP诱导的氧化应激损伤和改善免疫功能紊乱可能是其重要作用机制。

Objective:To observe the clinical effect of Fangji Huangqi Decoction and Yuebi Decoction plus Western Medicine on Nephrotic Syndrome in Children(lung-kidney qi deficiency,wind and water flooding).Methods:From January 2018 to March 2019,114 children with nephrotic syndrome in our hospital were selected as the study subjects,and the patients were divided into control group and observation group with 57 cases each by random number table.The control group was treated with Western medicine,while the observation group was treated with Fangji Huangqi Decoction and Yuebi Decoction on the basis of the control group.The serum albumin(Alb),T lymphocyte subsets,24-hour urinary protein,total cholesterol(TC),serum creatinine,retinol binding protein(RBP)and cholinesterase(CHE)were observed before and after treatment in two groups,and the clinical efficacy and incidence of adverse reactions were counted.Results:After treatment,Alb in two groups was higher than that before treatment,24-hour urinary protein,TC and creatinine were lower than that before treatment,and the improvement of the above-mentioned indexes in the observation group was higher than that in the control group,the difference was statistically significant(P<0.05).After treatment,the CD+4 T cells and ratio of CD+4/CD+8 T cells in the two groups was significantly higher than that before treatment(P<0.05),and those in the observation group were significantly higher than in the control group(P<0.05).After treatment,the levels of RBP and CHE in the two groups were significantly lower than those before treatment(P<0.05),and the levels in the observation group were significantly lower than those in the control group(P<0.05).There were no obvious adverse reactions during the treatment in the two groups.Conclusion:The Fangji Huangqi Decoction and Yuebi Decoction plus Western Medicine on Nephrotic Syndrome in Children(lung-kidney qi deficiency,wind and water flooding)can improve laboratory indicators,improve clinical effect,alleviate oxidative stress injury induced by RBP and improve immune dysfunction may be its important mechanism.