犀角地黄汤治疗过敏性紫癜性肾炎临床研究

Clinical Study on Xijiao Dihuang Tang for Henoch-Schonlein Purpura Nephritis

目的:观察犀角地黄汤治疗过敏性紫癜性肾炎的临床疗效。方法:将过敏性紫癜肾炎患者60例随机分为2组,对照组27例采用西医常规治疗,观察组33例在对照组的基础上加用犀角地黄汤加味治疗,2组疗程均为2个月,观察比较2组临床疗效及治疗前后肾功能指标[尿素氮(BUN)、血肌酐(SCr)、24 h尿蛋白(24 h Upro)、血尿酸(BUA)及尿微量白蛋白(mAlb)]、凝血功能[血浆凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、凝血酶时间(TT)、纤维蛋白原含量(FIB)]、尿红细胞计数、T细胞亚群和NK细胞比例等的变化。结果:总有效率观察组为86.8%,对照组为62.5%,2组比较,差异有统计学意义(P <0.05)。治疗后,2组患者SCr、BUN、24 h Upro、BUA、mAlb及尿红细胞计数均较治疗前降低(P <0.05),且观察组上述各项指标均低于对照组(P <0.05)。治疗后,2组患者APTT、PT、TT值均较治疗前升高(P <0.05),FIB含量较治疗前降低(P <0.05);且观察组上述各项指标改善优于对照组(P <0.05)。治疗后,观察组CD4^+/CD8^+以及CD16^+CD56^+NK细胞水平较对照组升高(P <0.05),CD8^+T细胞水平较对照组降低(P <0.05),CD3+T细胞、CD4+T细胞水平2组差异不大(P> 0.05)。观察组外周血CD4+T细胞、CD3+T细胞水平前后差值低于对照组,CD4^+/CD8+以及CD16^+CD56^+NK水平前后差值高于对照组,差异均有统计学意义(P <0.05)。结论:犀角地黄汤治疗过敏性紫癜性肾炎可有效改善患者肾功能、免疫功能及凝血功能,临床疗效显著。

Objective:To observe the clinical effect of Xijiao Dihuang tang for Henoch-Schonlein purpura nephritis Methods:Divided 60 cases of patients with Henoch-Schonlein purpura nephritis into two groups randomly,27 cases in the control group and 33 cases in the observation group.The control group received routine western medicine treatment,while the observation group additionally received modified Xijiao Dihuang tang.The treatment of both groups lasted for 2 months.Observed and compared the clinical effect and changes in indexes of renal function[blood urea nitrogen(BUN),serum creatinine(Scr),24-hour urinary protein(24 h Upro),blood uric acid(BUA),urinary albumin(mAlb)],indexes of coagulation function[plasma prothrombin time(PT),activated partial thromboplastin time(APTT),thrombin time(TT),fibrinogen content(FIB)],urine red blood cell count and proportions of T lymphocyte subsets and NK cells in both groups before and after treatment.Results:The total effective rate was 86.8%in the observation group and 62.5%in the control group,difference being significant(P<0.05).After treatment,the contents of Scr,BUN,24 h Upro excretion,BUA and mAlb and urine red blood cell count in both groups were lower than those before treatment(P<0.05),and each index above in the observation group was lower than that in the control group(P<0.05).After treatment,APTT,PT and TT in both groups were longer than those before treatment(P<0.05),and the content of FIB was lower than that before treatment(P<0.05);each index above in the observation group was improved better than that in the control group(P<0.05).After treatment,the levels of CD4^+/CD8^+and CD16^+CD56^+NK cells in the observation group were higher than those in the control group(P<0.05),the level of CD8^+T cells was lower than that in the control group(P<0.05),and there was no significant difference being found in the levels of CD3^+T cells and CD4^+T cells in both groups(P>0.05).The differential values in the levels of CD4^+T cells and CD3^+T cells in the peripheral blood of the observation group before and after treatment were respectively lower than those of the control group,and the differential values in the levels of CD4^+/CD8^+and CD16^+CD56^+NK cells in the peripheral blood of the observation group before and after treatment were respectively higher than those of the control group,differences being significant(P<0.05).Conclusion:Xijiao Dihuang tang has significant clinical effect in treating Henoch-Schonlein purpura nephritis,which can effectively improve the renal function,immune function and coagulation function.