防己黄芪汤合五苓散加减联合西药治疗肺脾气虚证小儿肾病综合征临床研究

Clinical Study on Fangji Huangqi Tang and Modified Wuling Powder Combined with Western Medicine for Nephrotic Syndrome in Children of Lung-Spleen Qi Deficiency Syndrome

目的:观察防己黄芪汤合五苓散加减联合西药治疗肺脾气虚证小儿肾病综合征的临床疗效。方法:将肺脾气虚证肾病综合征患儿60例按随机数字表法分为对照组和观察组各30例。对照组给予醋酸泼尼松片等西医常规治疗;观察组在对照组的基础上给予防己黄芪汤合五苓散加减治疗。2组均连续治疗12周,比较2组肝肾功能[血清白蛋白(Alb)、尿素氮(BUN)、血肌酐(SCr)]、肺脾气虚证证候评分及临床疗效。结果:观察组总有效率为93.33%,对照组为66.67%,2组比较,差异有统计学意义(P<0.05)。治疗前,2组血清Alb、BUN、SCr水平比较,差异无统计学意义(P>0.05)。治疗后,2组血清Alb水平均较治疗前明显升高,BUN、SCr水平均较治疗前明显下降(P<0.05),且观察组上述指标改善较对照组更显著(P<0.05)。治疗前,2组浮肿、纳呆、面色苍白、身重困倦、气短乏力、自汗、便溏、小便短少等肺脾气虚证证候评分比较,差异无统计学意义(P>0.05);治疗后,2组上述各项中医证候评分均较治疗前明显降低(P<0.05),且观察组各项中医证候评分低于对照组(P<0.05)。结论:在西医常规治疗的基础上,应用防己黄芪汤合五苓散加减治疗肺脾气虚证小儿肾病综合征疗效显著,能明显改善患儿的肾功能和中医证候。

Objective:To observe the clinical effect of the therapy of Fangji Huangqi tang and modified Wuling powder combined with western medicine on children with nephrotic syndrome of lung-spleen qi deficiency syndrome.Methods:A total of 60 children with nephrotic syndrome were randomly divided into the control group and the observation group according to random number table,with 30 cases in each group.The control group was given prednisone acetate tablets and other conventional western medicine;the observation group was additionally treated with Fangji Huangqi tang and modified Wuling powder based on the treatment of the control group.Both groups were treated for 12 weeks.The indexes of liver and kidney function,including serum albumin(Alb),urea nitrogen(BUN)and serum creatinine(Scr),the scores of lung-spleen qi deficiency syndrome and clinical effects were compared between the two groups.Results:The total effective rate was 93.33%in the observation group and 66.67%in the control group,the difference being significant(P<0.05).Before treatment,there was no significant difference in the levels of serum Alb,BUN and SCr between the two groups(P>0.05).After treatment,the levels of serum Alb in both groups were significantly increased,and the levels of BUN and SCr were significantly decreased(P<0.05),and the improvement of the above levels in the observation group was more significant than that in the control group(P<0.05).Before treatment,there was no significant difference in the scores of lung-spleen qi deficiency syndrome in both groups,such as edema,poor appetite and digestion,pale face,a heavy body and fatigue,shortness of breath and lack of strength,spontaneous sweating,thin and unformed stools,short and insufficient urine(P>0.05).After treatment,the above syndrome scores in both groups were significantly decreased when compared with those before treatment(P<0.05),and the above syndrome scores in the observation group were lower than those in the control group(P<0.05).Conclusion:On the basis of the conventional western medicine,the application of Fangji Huangqi tang and modified Wuling powder has a significant therapeutic effect on the treatment of nephrotic syndrome in children of lung-spleen qi deficiency syndrome,which can obviously improve the kidney function and Chinese medicine syndromes of the children.