温阳健脾化瘀汤联合强的松、环磷酰胺治疗儿童肾病综合征的疗效观察

Clinical Effect Observation of Wenyangjianpihuayu Soup Combined with Prednisone and Cyclophosphamide in the Treatment of Children with Nephrotic Syndrome

目的 :探讨温阳健脾化瘀汤联合强的松、环磷酰胺治疗儿童肾病综合征的效果及对白细胞介素(IL)-1、IL-6、IL-8和肿瘤坏死因子(TNF)-α的影响。方法 :选取2014年2月-15年12月我院收治的70例肾病综合征患儿为研究对象,所有患儿均符合脾肾阳虚型的中医辨证分型标准,按随机数字表法分为观察组和对照组,各35例。观察组予以温阳健脾化瘀汤联合强的松(1 mg/kg,qd,2周后用量逐渐减少,递减控制在10%,直到维持剂量0.2 mg/kg,qd)、环磷酰胺(8~12 mg/kg,qd)治疗,对照组给予强的松(同观察组)、环磷酰胺(同观察组)治疗。观察比较两组治疗前后相关因子水平以及临床疗效、复发率。结果 :治疗后,两组IL-1、IL-6、IL-8、TNF-α、血肌酐、血浆白蛋白、24 h尿蛋白量均较治疗前显著降低(P<0.05),且观察组各项指标水平均低于对照组(P<0.05);观察组治疗总有效率显著高于对照组,复发率显著低于对照组(P<0.05)。结论 :温阳健脾化瘀汤联合强的松、环磷酰胺治疗肾病综合征有效抑制了炎症反应、改善了肾功能,临床效果显著,且复发率低。

Objective:To evaluate the effects of wenyangjianpihuayu soup combined with prednisone and cyclophosphamide on children with nephrotic syndrome and their effects on interleukin(IL)-1,IL-6,IL-8 as well as tumor necrosis factor(TNF)-α.Methods:From February 2014 to December,70 cases of child nephrotic syndrome in our hospital were selected as the study object,all the children were diagnosed as asdthenic splenonephro-yang type according to TCM syndrome differentiation criteria.Participants were randomly divided into the control group and the observation group.The observation group was treated with wenyangjianpihuayu soup combined with prednisone(initial dose was 1 mg/kg,qd,after two weeks,the dose was gradually decreasing until it came up to 0.2 mg/kg,qd,the dose should be reduced no more than 10% every time) and cyclophosphamide(8~12 mg/kg,qd) while the control group received prednisone(same as the observation group) and cyclophosphamide(same as the observation group) treatment.The changes of related factors,clinical efficacy and recurrence rate were observed and compared between the two groups before and after treatment.Results:After treatment,there were significantly reduce in IL-1,IL-6,IL-8,TNF-α,serum creatinine,serum albumin,24 h urine protein levels after treatment compared with those before treatment(P<0.05).Futhermore,these indicators showed significant difference between the experimental group and control group(P<0.05).Besides,the total effective rate was significantly higher in the observation group than the control group,and the recurrence rate was significantly lower than the control group as well(P<0.05).Conclusion:Wenyangjianpihuayu soup combined with prednisone and cyclophosphamide shows effective curative effect in treatment of children with nephrotic syndrome,resulting in improved renal function as well as low recurrence rate.