清热止血方联合雷公藤多苷治疗儿童紫癜性肾炎疗效及其对血清sFlt-1、vWF的影响

Curative Effect of Qingre Zhixue Recipe Combined with Tripterygium Glycosides in Treatment of Henoch Schonlein Purpura Nephritis in Children and Its Effect on Serum sFlt-1 and vWF

目的:探讨清热止血方联合雷公藤多苷治疗紫癜性肾炎患儿的临床疗效,为临床应用提供依据。方法:收集紫癜性肾炎患儿45例,使用中央随机系统按1:2分为对照组15例,观察组30例,对照组给予贝那普利联合双嘧达莫治疗,观察组给予清热止血方联合雷公藤多苷治疗,疗程12周,观察2组患儿治疗4、8、12周的临床疗效及不良事件发生率,Elisa法检测血清可溶性血管内皮生长因子受体(soluble vascular endothelial growth factor receptor,sFlt)-1、血管性血友病因子(von Willebrand factor,vWF)的变化。结果:治疗4周观察组降低蛋白尿疗效高于对照组,差异有统计学意义(P<0.05);2组治疗8、12周降低尿蛋白疗效比较差异无统计学意义(P>0.05)。观察组与对照组在治疗12周时血清sFlt-1、vWF水平均较治疗前显著下降(P<0.05);观察组在治疗4周时,血清sFlt-1表达水平较对照组明显下降(P<0.05),2组患儿治疗期间均有轻度不良事件发生,组间比较差异无统计学意义(P>0.05)。结论:清热止血方联合雷公藤多苷能有效降低紫癜性肾炎患儿尿蛋白量,下调血清sFlt-1、vWF水平,与对照组比较起效更快且无明显不良反应。

Objective:To observe the curative effect of Qingre Zhixue recipe combined with Tripterygium Glycosides(TG)on children with Henoch Schonlein purpura nephritis(HSPN)and its effect on serum soluble vascular endothelial growth factor receptor 1(sFlt-1)and von Willebrand factor(vWF),so as to provide research basis for its clinical application.Method:45 children with HSPN were divided into control group(15 cases)and observation group(30 cases)by the central random system at the ratio of 1:2.The control group received benazepril tablets combined with dipyridamole tablets,and the observation group received Qingre Zhixue recipe and TG.Both groups were treated for 12 weeks.The curative effect and incidence of adverse events were observed after 4,8,and 12 weeks of treatment.The levels of serum sFlt-1 and vWF were detected by Elisa.Result:The effective rate of the observation group was higher than that of the control group at 4 weeks,and the difference was statistically significant(P<0.05).There was no significant difference between the two groups at 8 and 12 weeks(P>0.05).The levels of serum sFlt-1 and vWF of the two groups were lower than before after 12 weeks,and the difference was statistically significant(P<0.05).At 4 weeks,the level of serum sFlt-1 in the observation group was significantly lower than that in the control group(P<0.05),but there was no significant difference in the serum vWF level between two groups(P>0.05).There was no significant difference in serum sFlt-1 and vWF levels between two groups at 8 and 12 weeks(P>0.05).Mild adverse events were observed in the two groups,the difference was not statistically significant(P>0.05).Conclusion:Qingre Zhixue recipe combined with TG could effectively reduce urinary protein and down-regulate the level of serum sFlt-1,vWF on children with HSPN.Compared with the control group,this treatment method had faster effect and no obvious adverse reactions.