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目的探讨槐杞黄颗粒对儿童原发性肾病综合征(PNS)的治疗作用及对细胞、体液免疫的影响。方法采用前瞻性研究方法将68例住院并初诊为PNS的患儿随机分为泼尼松联合槐杞黄颗粒治疗组(观察组,33例)和单用泼尼松治疗组(对照组,35例)。比较两组患儿随访至9个月时PNS复发率、维持缓解率、感染发生率,6个月时隔日泼尼松用量及3、6、9个月时血清白蛋白、胆固醇水平及细胞、体液免疫功能。结果观察组的感染发生率低于对照组,差异有统计学意义(P<0.05),无复发维持缓解率高于对照组,差异有统计学意义(P<0.05),6个月时隔日泼尼松用量小于对照组,差异有统计学意义(P<0.05);随访至3、6个月时,两组血清白蛋白、胆固醇水平及细胞、体液免疫学指标检测差异均无统计学意义(P均>0.05),至9个月时观察组血清白蛋白明显高于对照组,差异有统计学意义(P<0.001),胆固醇两组比较差异无统计学意义(P>0.05),观察组CD3、CD4、CD19、NK百分比和血清IgA、IgG、IgM水平明显提高,CD8百分比明显降低,CD4/CD8比率明显增高,与对照组比较差异均有统计学意义(P<0.05、P<0.01或P<0.001);未发现槐杞黄相关的不良反应。结论槐杞黄可减少PNS患儿复发率、维持较长时间的缓解,减少感染发生率及泼尼松用量,长期应用可提高PNS患儿的细胞和体液免疫功能,且显示了其治疗的安全性,对血浆胆固醇水平无影响。
Objective To investigate the therapeutic effect of Huai Qi Huang granules on children with primary nephrotic syndrome (PNS) and its effect on cellular and humoral immunity. Methods A total of 68 children hospitalized and newly diagnosed as PNS were randomly divided into prednisone combined with Huaiqi Huang Granule group (observation group, 33 cases) and prednisone alone group (control group, 35 example). PNS relapse rate, maintenance remission rate, incidence of infection, prednisone dosage at 6 months and serum albumin, cholesterol levels and cells at 3, 6 and 9 months of follow-up were compared between the two groups. Humoral immune function. Results The incidence of infection in the observation group was lower than that in the control group (P <0.05), and the recurrence-free survival rate was higher in the observation group than in the control group (P <0.05). After 6 months, The dosage of nisin was less than that of the control group (P <0.05). There was no significant difference in the levels of serum albumin, cholesterol, cell and humoral immunological indexes between the two groups at 3 and 6 months P> 0.05). Serum albumin in the observation group was significantly higher than that in the control group at 9 months (P <0.001), but there was no significant difference between the two groups (P> 0.05). The observation group The percentage of CD3, CD4, CD19, NK and serum IgA, IgG and IgM were significantly increased, the percentage of CD8 was significantly decreased and the ratio of CD4 / CD8 was significantly higher than that of the control group (P <0.05, P <0.01 or P <0.001); no side effects associated with Huaiqi yellow were found. Conclusions Huaiqihuang can reduce the relapse rate of PNS children, maintain a longer time to alleviate, reduce the incidence of infection and the amount of prednisone, long-term use can improve cellular and humoral immune function in children with PNS, and showed the safety of its treatment Sex, no effect on plasma cholesterol levels.