固本祛瘀化湿汤佐治小儿肾病综合征临床观察
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摘要
目的观察固本祛瘀化湿汤佐治小儿肾病综合征的治疗效果。方法选择2016年6月至2018年6月武威市凉州医院儿科收治住院的肾病综合征患儿50例为研究对象,随机分为对照组20例和观察组30例。对照组给予常规治疗,观察组在对照组治疗基础上给予固本祛瘀化湿汤辨证加减治疗,每日1剂,每12周为1个疗程,1个疗程结束后观察两组治疗后临床疗效、生化指标、尿蛋白转阴时间、水肿消退时间。结果治疗后两组患儿血浆白蛋白均显著高于治疗前,24 h尿蛋白定量、胆固醇均显著低于治疗前,差异有统计学意义(P<0.05)。治疗后观察组血浆白蛋白显著高于对照组,24 h尿蛋白定量、胆固醇均显著低于对照组,差异有统计学意义(P<0.05)。治疗后观察组血浆免疫球蛋白显著高于对照组,尿蛋白转阴及水肿消退时间显著少于对照组,差异均有统计学意义(P<0.05)。观察组总有效率为96.6%(29/30),高于对照组70.0%(14/20),差异有统计学意义(P<0.05)。治疗后观察组满月脸、感染、复发、胃肠道反应、高血糖发生率均低于对照组,差异有统计学意义(P<0.05)。两组痤疮、低血压发生率比较差异无统计学意义(P>0.05)。结论固本祛瘀化湿汤佐治肾病综合征可明显提高疗效,迅速改善临床症状,见效快,不良反应少,值得临床推广应用。
Objective To observe the therapeutic effect of Guben Quyu Huashi decoction on pediatric nephrotic syndrome.Methods Fifty cases of children with nephrotic syndrome admitted to the Department of Pediatrics of Wuwei Liangzhou Hospital from June 2016 to June 2018 were selected as study subjects, and were randomly divided into control group(20 cases) and observation group(30 cases).Both groups were given routine treatment, and the observation group was also treated with Guben Quyu Huashi decoction for syndrome differentiation and modified treatment one dose per day and 12 weeks as one course of treatment. After one course of treatment, the clinical efficacy, biochemical indexes, urine protein conversion time and edema regression time of the two groups after treatment were observed.Results After treatment, plasma albumin was significantly higher in the two groups than before treatment, and urine protein and cholesterol were significantly lower in the 24 h group than before treatment, with statistically significant differences(P<0.05).After treatment, plasma albumin in the observation group was significantly higher than that in the control group, and urine protein quantification and cholesterol in 24 hours were significantly lower than those in the control group, with statistically significant differences(P<0.05).After treatment, the plasma immunoglobulin of the observation group was significantly higher than that of the control group, and the duration of urine protein conversion to Yin and edema regression was significantly less than that of the control group, with statistically significant differences(P<0.05).The total effective rate in the observation group was higher than that in the control group[96.6%(29/30) vs 70.0%(14/20)], and the difference was statistically significant(P<0.05).After treatment, the incidence of full moon face, infection, recurrence, gastrointestinal reaction and hyperglycemia in the observation group was lower than that in the control group, with statistically significant differences(P<0.05).There was no significant difference in the incidence of acne and hypotension between the two groups(P>0.05).Conclusion Guben Quyu Huashi decoction can significantly improve the effect of treatment for nephrotic syndrome, rapidly improve the clinical symptoms, with quick effect and less adverse reactions, which is worthy of clinical application.
Objective To observe the therapeutic effect of Guben Quyu Huashi decoction on pediatric nephrotic syndrome.Methods Fifty cases of children with nephrotic syndrome admitted to the Department of Pediatrics of Wuwei Liangzhou Hospital from June 2016 to June 2018 were selected as study subjects, and were randomly divided into control group(20 cases) and observation group(30 cases).Both groups were given routine treatment, and the observation group was also treated with Guben Quyu Huashi decoction for syndrome differentiation and modified treatment one dose per day and 12 weeks as one course of treatment. After one course of treatment, the clinical efficacy, biochemical indexes, urine protein conversion time and edema regression time of the two groups after treatment were observed.Results After treatment, plasma albumin was significantly higher in the two groups than before treatment, and urine protein and cholesterol were significantly lower in the 24 h group than before treatment, with statistically significant differences(P<0.05).After treatment, plasma albumin in the observation group was significantly higher than that in the control group, and urine protein quantification and cholesterol in 24 hours were significantly lower than those in the control group, with statistically significant differences(P<0.05).After treatment, the plasma immunoglobulin of the observation group was significantly higher than that of the control group, and the duration of urine protein conversion to Yin and edema regression was significantly less than that of the control group, with statistically significant differences(P<0.05).The total effective rate in the observation group was higher than that in the control group[96.6%(29/30) vs 70.0%(14/20)], and the difference was statistically significant(P<0.05).After treatment, the incidence of full moon face, infection, recurrence, gastrointestinal reaction and hyperglycemia in the observation group was lower than that in the control group, with statistically significant differences(P<0.05).There was no significant difference in the incidence of acne and hypotension between the two groups(P>0.05).Conclusion Guben Quyu Huashi decoction can significantly improve the effect of treatment for nephrotic syndrome, rapidly improve the clinical symptoms, with quick effect and less adverse reactions, which is worthy of clinical application.
引文
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[8] 李翠萍,温玉玲,宋丽华,等.温补肾阳及活血化瘀法治疗小儿肾病综合征(脾肾阳虚兼血瘀型)疗效观察[J].中国中西医结合儿科学,2011,3(4):324-325.
[9] 郑攀,郑宏,郑启仲.小儿肾病综合征从“痰瘀虚”论治经验[J].中华中医药杂志,2012,27(7):1859-1861.
[10] 袁斌,任辉杰.肺脾不足是小儿肾病综合征复发的关键[J].中医儿科杂志,2007,3(4):9-10.
[11] 丁楠,郝丽,黎淮,等.原发性肾病综合征患者免疫指标变化的临床意义探讨[J].中国免疫学杂志,2011,27(4):356-359.
[2] 中华医学会儿科学分会肾脏病学组.儿童常见肾脏疾病诊治循证指南(一):激素敏感、复发/依赖肾病综合征诊治循证指南(试行)[J].中华儿科杂志,2009,47(3):167-170.
[3] 高春林,夏正坤.激素耐药型肾病综合征诊治循证指南(2016)解读[J].中华儿科杂志,2017,55(11):810-812.
[4] 国家中医药管理局.中医病证诊断疗效标准[M].北京:中国中医药出版社,2013:292.
[5] 汪受传,虞坚尔.中医儿科学[M].北京:中国中医药出版社,2017:197-204.
[6] 朱聪,孙莹,高峰,等.补肾胶囊治疗脾肾阳虚型肾病综合征[J].长春中医药大学学报,2014,30(5):901-902.
[7] 边东,寇杰,刘明武,等.益气补肾化瘀通络中药对原发性肾病综合征激素维持治疗阶段的治疗作用研究[J].河北中医,2013,35(12):1774-1776.
[8] 李翠萍,温玉玲,宋丽华,等.温补肾阳及活血化瘀法治疗小儿肾病综合征(脾肾阳虚兼血瘀型)疗效观察[J].中国中西医结合儿科学,2011,3(4):324-325.
[9] 郑攀,郑宏,郑启仲.小儿肾病综合征从“痰瘀虚”论治经验[J].中华中医药杂志,2012,27(7):1859-1861.
[10] 袁斌,任辉杰.肺脾不足是小儿肾病综合征复发的关键[J].中医儿科杂志,2007,3(4):9-10.
[11] 丁楠,郝丽,黎淮,等.原发性肾病综合征患者免疫指标变化的临床意义探讨[J].中国免疫学杂志,2011,27(4):356-359.