摘要
目的:观察加味犀角地黄汤辨治儿童紫癜性肾炎血热夹瘀证的临床疗效及对炎症因子和凝血功能的影响。方法:将122例患者采用随机数字表法分为对照组60例和观察组62例。对照组口服醋酸泼尼松龙片,1. 5~2 mg·kg^-1·d^-1,4周后改为隔日口服,经4周后再逐渐减量;口服双嘧达莫片,3~5 mg·kg^-1·d^-1;口服复方芦丁片,1片/次,3次/d。观察组在对照组治疗的基础上采用加味犀角地黄汤辨证内服,1剂/d。两组均连续治疗12周。进行治疗前后血热夹瘀证评分;检测治疗前后尿β2微球蛋白(β2-MG),24 h尿蛋白定量(24 h UmAlb),尿微量蛋白(mAlb),胱抑素C(CysC),血小板计数(PLT),血浆凝血酶原时间(PT),活化部分凝血酶原时间(APTT),白细胞介素-2(IL-2),IL-4,IL-10,肿瘤坏死因子-α(TNF-α),血管性假性血友病因子(vWF),血小板活化因子(PAF),血栓调节蛋白(TM),血浆纤维蛋白原(FIB),尿红细胞(RBC)和尿蛋白(PRO)情况。结果:观察组临床疗效总有效率为95. 16%,高于对照组的81. 54%(χ^2=5. 466,P <0. 05);观察组中医证候总有效为96. 77%,高于对照组的75%(χ^2=12. 052,P <0. 01);治疗后观察组患儿β2-MG,24 h UmAlb,mAlb,CysC水平均明显低于对照组(P <0. 01);治疗后两组患者PT均较治疗前延长(P <0. 05),观察组延长更为显著(P <0. 05);治疗后观察组FIB水平低于对照组(P <0. 05);观察组患儿血清IL-4,IL-10和TNF-α水平均低于对照组,IL-2水平高于对照组(P <0. 01);观察组患儿vWF,PAF和TM水平均低于对照组(P <0. 01)。结论:在常规激素治疗的基础上,服用加味犀角地黄汤辨治HSPN血热夹瘀证患儿,可起到护保肾功能,减轻蛋白尿、血尿,有明显的临床疗效,并具有抗炎、改善凝血功能的作用。
Objective: To observe the clinical effect of Jiawei Xijiao Dihuang Tang on Henoch-schonlein purpura nephritis of children with blood heat and stasis syndrome and the inflammatory factors and coagulation function. Method: One hundred and twenty-two patients were divided into control group( 60 cases) and observation group( 62 cases) by random number table. Patients in control group got prednisolone acetate tablets every day,1. 5-2 mg·kg^-1·d^-1,after 4 weeks,of the treatment,and the 4 weeks dosage decreased progressively.Patients in control group also got dipyridamole tablets,3-5 mg·kg^-1·d^-1,and compound rutin tablets,1 tablet/day,3 times/days. In addition to the therapy of control group,patients in observation group were also given Jiawei Xijiao Dihuang Tang,1 dose/day. And one course of treatment was 12 weeks. Before and after treatment,blood heat and stasis syndrome were graded. And levels of urinary β2 microglobulin( β2-MG),24-hour urine protein quantitative( 24 h UmAlb),microalbuminuria( mAlb),cystatin C( CysC),platelet count( PLT),plasma prothrombin time( PLT), plasma prothrombin time( PT), activated partial thromboplastin time( APTT),interleukins-2( IL-2),IL-4,IL-10,tumor necrosis factor-α( TNF-α),von willebrand factor( vWF),platelet activating factor( PAF),thrombomodulin( TM),plasma fibrinogen( FIB),urine RBC and urine protein( PRO)were detected. Result: The total clinical effect in observation group was 95. 16%,which was higher than 81. 54%in control group( χ^2= 5. 466,P < 0. 05). And the total symptoms of traditional Chinese medicine( TCM) was96. 77%,which was higher than 75% in control groups( χ^2= 12. 052,P < 0. 01). After treatment,levels of β2-MG,24 h UmAlb,mAlb and CysC were higher than those in control groups( P < 0. 01). And PT in both groups prolonged,particularly in observation group( P < 0. 05). Level of FIB in observation group was lower than that in control groups( P < 0. 05). And levels of IL-4,IL-10,TNF-α and vWF,PAF and TM were lower than those in control groups,but level of I
作者
覃玉芳
李贵平
QIN Yu-fang;LI Gui-ping(Affiliated Hospital of Traditional Chinese Medicine of Southwest Medical University,Luzhou 646000,China)
出处
《中国实验方剂学杂志》
CAS
CSCD
北大核心
2019年第2期144-149,共6页
Chinese Journal of Experimental Traditional Medical Formulae
基金
四川省教育厅面上项目(16ZZ149)
关键词
紫癜性肾炎
血热夹瘀证
犀角地黄汤
抗炎
凝血功能
肾功能
henoch-schonlein purpura nephritis
blood heat and stasis syndrome
Xijiao Dihuang Tang
anti-inflammation
coagulation function
renal function
