复方甘草酸苷辅助治疗儿童紫癜性肾炎疗效观察
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摘要
目的:探讨复方甘草酸苷在儿童紫癜性肾炎中的应用价值。方法:选择2015-2017年我院儿科收治的紫癜性肾炎患儿90例,按随机数表法分为对照组和观察组各45例。对照组采用常规方案治疗,即静脉给予维生素C和钙剂,同时给予激素、抗过敏、抗凝、雷公藤多苷片等治疗;观察组患儿在对照组基础上加用复方甘草酸苷辅助治疗,3～5岁80 mg,6～14岁120 mg,口服,1次/天。30 d为1个疗程,两组患儿均治疗2个疗程。观察两组患儿临床症状缓解情况,比较治疗前后血清炎症因子水平和免疫功能的情况。结果:观察组紫癜消失时间、肾损害恢复时间、关节疼痛消失时间及水肿消失时间均少于对照组(P均<0.05)。治疗前两组患儿游离细胞间黏附分子-1(sICAM-1)、基质金属蛋白酶-9(MMP-9)、T淋巴细胞亚群水平比较差异均无统计学意义(P均>0.05);治疗后两组患儿sICAM-1、MMP-9和CD8~+水平均降低,且观察组低于对照组(P均<0.05),CD3~+、CD4~+和CD4~+/CD8~+水平均升高,且观察组高于对照组(P均<0.05)。结论:复方甘草酸苷辅助治疗紫癜性肾炎患儿,可显著缓解炎症应激反应和提高免疫功能,改善临床症状,值得临床推广应用。
Objective: To investigate the application value of compound glycyrrhisim in the treatment of children with HenochSch?nlein purpura nephritis. Methods: Totally 90 patients with Henoch-Sch?nlein purpura nephritis admitted into pediatrics of our hospital from 2015 to 2017 were selected to be divided into the control group and the observation group via the random number table,with 45 cases in each group. The control group was treated with conventional regimen,namely,intravenous vitamin C and calcium,and hormone,anti-allergic, anticoagulant and tripterygium glycosides tablets. The observation group additionally received compound glycyrrhizin on the basis of the control group,80 mg at the age of 3 to 5 years and 120 mg at the age of 6 to 14 years,orally,once a day.A total of 30 d was a course of treatment,and both groups were treated for 2 courses. The clinical symptoms of two groups were observed,the changes of levels of serum inflammatory factors and immune function were compared before and after treatment. Results: The disappearance time of Henoch-Sch?nlein purpura,the recovery time of renal damage,the disappearance time of joint pain and edema in the observation group were less than those in the control group(P<0.05). There was no significant difference in the levels of free intercellular celladhesionmolecles-1(sICAM-1),matrix metalloproteinase-9(MMP-9) and T lymphocyte subsets between two groups before treatment(P>0.05). After treatment,the levels of sICAM-1,MMP-9 and CD8~+were decreased in both groups,and the observation group was lower than the control group(P<0.05); the levels of CD3~+,CD4~+and CD4~+/CD8~+were elevated,and the observation group was higher than the control group(P<0.05). Conclusion: Compound glycyrrhizin supplementation in children with Henoch-Sch?nlein purpura nephritis can significantly alleviate the inflammatory stress response,promote the immune function and improve the clinical symptoms,which is worthy of clinical application.
Objective: To investigate the application value of compound glycyrrhisim in the treatment of children with HenochSch?nlein purpura nephritis. Methods: Totally 90 patients with Henoch-Sch?nlein purpura nephritis admitted into pediatrics of our hospital from 2015 to 2017 were selected to be divided into the control group and the observation group via the random number table,with 45 cases in each group. The control group was treated with conventional regimen,namely,intravenous vitamin C and calcium,and hormone,anti-allergic, anticoagulant and tripterygium glycosides tablets. The observation group additionally received compound glycyrrhizin on the basis of the control group,80 mg at the age of 3 to 5 years and 120 mg at the age of 6 to 14 years,orally,once a day.A total of 30 d was a course of treatment,and both groups were treated for 2 courses. The clinical symptoms of two groups were observed,the changes of levels of serum inflammatory factors and immune function were compared before and after treatment. Results: The disappearance time of Henoch-Sch?nlein purpura,the recovery time of renal damage,the disappearance time of joint pain and edema in the observation group were less than those in the control group(P<0.05). There was no significant difference in the levels of free intercellular celladhesionmolecles-1(sICAM-1),matrix metalloproteinase-9(MMP-9) and T lymphocyte subsets between two groups before treatment(P>0.05). After treatment,the levels of sICAM-1,MMP-9 and CD8~+were decreased in both groups,and the observation group was lower than the control group(P<0.05); the levels of CD3~+,CD4~+and CD4~+/CD8~+were elevated,and the observation group was higher than the control group(P<0.05). Conclusion: Compound glycyrrhizin supplementation in children with Henoch-Sch?nlein purpura nephritis can significantly alleviate the inflammatory stress response,promote the immune function and improve the clinical symptoms,which is worthy of clinical application.
引文
[1]徐铁华.丹芍汤佐治小儿过敏性紫癜肾炎疗效观察[J].儿科药学杂志,2016,22(10):21-23.
[2]SATOSKAR A A,SULEIMAN S,AYOUB I,et al.Staphylococcus infection-associated GN-spectrum of IgA staining and prevalence of ANCA in a single-center cohort[J].Clin J Am Soc Nephrol,2017,12(1):39-49.
[3]胡晓忠.复方甘草酸苷对过敏性紫癜患儿细胞免疫功能及血清细胞因子水平的影响[J].中国基层医药,2016(24):3760-3764.
[4]牛文忠,张雪松,丁显春.复方甘草酸苷注射液辅助治疗过敏性紫癜临床观察及其对Th1/Th2型细胞因子水平的影响[J].中国皮肤性病学杂志,2017,31(2):144-146.
[5]胡亚美,江载芳.诸福棠实用儿科学[M].第7版.北京:人民卫生出版社,2012:688-690.
[6]厉洪江,刘翠华,田明,等.百令胶囊辅助治疗过敏性紫癜肾炎患儿的临床观察[J].中国药房,2016,27(32):4546-4548.
[7]FOTIS L,TUTTLE P V,BASZIS K W,et al.Azathioprine therapy for steroid-resistant Henoch-Sch9nlein purpura:A report of 6 cases[J].Pediatric rheumatology,2016,14(1):1-7.
[8]黄应波,唐雪梅.儿童紫癜肾炎的高危因素及预后判断[J].儿科药学杂志,2015,21(9):58-61.
[9]伍婕.复方甘草酸苷联合枸地氯雷他定治疗慢性特发性荨麻疹的临床研究[J].现代药物与临床,2017,32(4):693-697.
[10]白明辉.枸地氯雷他定联合复方甘草酸苷治疗慢性荨麻疹临床研究[J].中国麻风皮肤病杂志,2016,32(9):546-566.
[11]郭若男,郭瑞,魏洁如,等.西咪替丁联合复方甘草酸苷治疗小儿过敏性紫癜疗效及对血清cTnⅠ、s ICAM-1和MMP-9的影响[J].现代中西医结合杂志,2018,27(8):847-850.
[12]陈莹华.ESM-1和s ICAM-1在儿童过敏性紫癜和紫癜性肾炎中的变化及意义[D].郑州大学,2017.
[13]夏科君,单淑琴,赵蓓.低分子肝素钙联合百令胶囊对紫癜性肾炎患儿的临床疗效及对血清hs-CRP、MMP-9、APN、CysC的影响[J].中国生化药物杂志,2017,35(5):106-109.
[14]焦宏,张辉,佟月娟,等.过敏性紫癜肾炎患儿外周血淋巴细胞的变化特点[J/OL].中华实验和临床感染病杂志:电子版,2015,9(5):661-664.
[15]饶洪江.复方甘草酸苷联合西咪替丁对过敏性紫癜患儿体征改善及血清T细胞亚群、IL-1β水平变化的影响[J].中国血液流变学杂志,2017,27(1):86-88.
[2]SATOSKAR A A,SULEIMAN S,AYOUB I,et al.Staphylococcus infection-associated GN-spectrum of IgA staining and prevalence of ANCA in a single-center cohort[J].Clin J Am Soc Nephrol,2017,12(1):39-49.
[3]胡晓忠.复方甘草酸苷对过敏性紫癜患儿细胞免疫功能及血清细胞因子水平的影响[J].中国基层医药,2016(24):3760-3764.
[4]牛文忠,张雪松,丁显春.复方甘草酸苷注射液辅助治疗过敏性紫癜临床观察及其对Th1/Th2型细胞因子水平的影响[J].中国皮肤性病学杂志,2017,31(2):144-146.
[5]胡亚美,江载芳.诸福棠实用儿科学[M].第7版.北京:人民卫生出版社,2012:688-690.
[6]厉洪江,刘翠华,田明,等.百令胶囊辅助治疗过敏性紫癜肾炎患儿的临床观察[J].中国药房,2016,27(32):4546-4548.
[7]FOTIS L,TUTTLE P V,BASZIS K W,et al.Azathioprine therapy for steroid-resistant Henoch-Sch9nlein purpura:A report of 6 cases[J].Pediatric rheumatology,2016,14(1):1-7.
[8]黄应波,唐雪梅.儿童紫癜肾炎的高危因素及预后判断[J].儿科药学杂志,2015,21(9):58-61.
[9]伍婕.复方甘草酸苷联合枸地氯雷他定治疗慢性特发性荨麻疹的临床研究[J].现代药物与临床,2017,32(4):693-697.
[10]白明辉.枸地氯雷他定联合复方甘草酸苷治疗慢性荨麻疹临床研究[J].中国麻风皮肤病杂志,2016,32(9):546-566.
[11]郭若男,郭瑞,魏洁如,等.西咪替丁联合复方甘草酸苷治疗小儿过敏性紫癜疗效及对血清cTnⅠ、s ICAM-1和MMP-9的影响[J].现代中西医结合杂志,2018,27(8):847-850.
[12]陈莹华.ESM-1和s ICAM-1在儿童过敏性紫癜和紫癜性肾炎中的变化及意义[D].郑州大学,2017.
[13]夏科君,单淑琴,赵蓓.低分子肝素钙联合百令胶囊对紫癜性肾炎患儿的临床疗效及对血清hs-CRP、MMP-9、APN、CysC的影响[J].中国生化药物杂志,2017,35(5):106-109.
[14]焦宏,张辉,佟月娟,等.过敏性紫癜肾炎患儿外周血淋巴细胞的变化特点[J/OL].中华实验和临床感染病杂志:电子版,2015,9(5):661-664.
[15]饶洪江.复方甘草酸苷联合西咪替丁对过敏性紫癜患儿体征改善及血清T细胞亚群、IL-1β水平变化的影响[J].中国血液流变学杂志,2017,27(1):86-88.