小蓟饮子加减联合来氟米特治疗孤立性血尿型紫癜性肾炎(湿热下注型)疗效观察

Observation on the therapeutic effect of modified Xiaojiyinzi combined with leflunomide in the treatment of isolated hematuria purpura nephritis(damp heat injection type)

目的应用小蓟饮子加减联合来氟米特与单纯来氟米特治疗孤立性血尿型紫癜性肾炎患者,观察两组患者尿红细胞计数、肝功能、血常规及临床症状等变化,探讨小蓟饮子加减联合来氟米特对孤立性血尿型HSPN患者的疗效与安全性,为其在临床应用提供可靠依据。方法选择2015年4月至2020年3月河南中医药大学第一附属医院肾病门诊及住院患者,符合入组条件的患者60例,随机分为观察组、对照组各30例。观察组予小蓟饮子加减联合来氟米特,对照组予单纯来氟米特治疗,疗程8周,均于服药前后观察两组患儿中医证候积分,并检测尿红细胞计数、血常规、肝功能,比较两组差异性。结果观察组总有效率96.7%,对照组总有效率86.7%,观察组明显优于对照组(P<0.05)。治疗后观察组症状总积分明显低于对照组(P<0.05);对照组治疗前后ALT数值变化显著(P<0.05),治疗后对照组ALT数值较观察组明显升高(P<0.05)。结论小蓟饮子加减联合来氟米特能够明显改善孤立性血尿型紫癜性肾炎(湿热下注型)的临床症状,有效降低血尿,小蓟饮子加减方还能一定程度减少来氟米特的毒副作用。

Objective To observe the changes in urine red blood cell count,liver function,blood routine,and clinical symptoms in patients with isolated hematuria purpura nephritis treated with modified Xiaojiyinzi combined with leflunomide and simple leflunomide.To explore the efficacy and safety of modified Xiaojiyinzi combined with leflunomide in treating isolated hematuria HSPN patients and provide reliable basis for its clinical application.Methods Sixty patients who met the admission criteria were selected from the nephrology outpatient and inpatient departments of the First Affiliated Hospital of Henan University of Traditional Chinese Medicine from April 2015 to March 2020.They were randomly divided into an observation group and a control group,with 30 patients in each group.The observation group was treated with Xiaojiyinzi plus or minus combined with leflunomide,while the control group was treated with simple leflunomide for 8 weeks.The TCM syndrome scores of the two groups of children were observed before and after medication,and urine red blood cell count,blood routine,and liver function were measured to compare the differences between the two groups.Results The total effective rate of the observation group was 96.7%,while the total effective rate of the control group was 86.7%.The observation group was significantly better than the control group(P<0.05).After treatment,the total score of symptoms in the observation group was significantly lower than that in the control group(P<0.05);The ALT values in the control group showed significant changes before and after treatment(P<0.05),and after treatment,the ALT values in the control group were significantly higher than those in the observation group(P<0.05).Conclusion The combination of modified Xiaojiyinzi and leflunomide can significantly improve the clinical symptoms of isolated hematuria purpura nephritis(damp-heat injection type)and effectively reduce hematuria.The modified Xiaojiyinzi formula can also reduce the toxic side effects of leflunomide to a certain extent.