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目的:探讨护肾康复汤辅助激素治疗脾虚湿困型小儿复发性肾病综合征(PNS)的临床疗效及对血清炎性因子和血液高凝状态的影响。方法:将96例患儿随机按住院前后顺序分为观察组和对照组各48例。对照组采用激素治疗,观察组加用护肾康复汤辨证治疗。两组疗程均为4个月。检测24 h尿蛋白定量、血浆总蛋白(TP),白蛋白(ALB),总胆固醇(TC)和甘油三脂(TG)水平;检测纤维蛋白原(FIB),D-二聚体(D-D),血小板聚集率(MPAR),肿瘤坏死因子-α(TNF-α),超敏C-反应蛋白(hs-CRP),白细胞介素-6(IL-6)水平,治疗前后各评价1次;并监测心、肝、肾等安全性指标。结果:经Ridit分析,治疗后观察组临床疗效优于对照组(P<0.05);治疗后观察组24 h尿蛋白定量,TC和TG低于对照组(P<0.01),TP和ALB水平均高于对照组(P<0.01);治疗后观察组FIB,D-D和MPAR水平均低于对照组(P<0.01);治疗后观察组TNF-α,hs-CRP,IL-6水平均低于对照组(P<0.01)。结论:护肾康复汤辅助激素治疗儿童复发性PNS(脾虚湿困型)临床疗效优于单纯西医治疗,其作用机制可能与减轻炎症反应,调节脂代谢,改善血液高凝状态有关。
Objective: To investigate the clinical effects of Huanshen Kangfu Decoction adjuvant hormone therapy on spleen deficiency syndrome (PNS) and its effect on serum inflammatory factors and blood hypercoagulability. Methods: 96 cases of children were randomly divided into observation group and control group according to the order of 48 cases. The control group with hormone therapy, observation group plus Huashenkutang Decoction treatment. Two groups of treatment are 4 months. The contents of 24 h urinary protein, total protein (TP), albumin (ALB), total cholesterol (TC) and triglyceride (TG) were measured. Fibrinogen (FIB), D-dimer MPAR, TNF-α, hs-CRP and IL-6 were measured before and after treatment. And monitoring heart, liver, kidney and other safety indicators. Results: After Ridit analysis, the curative effect of the observation group was better than that of the control group (P <0.05). After 24 hours of treatment, the levels of urinary protein, TC and TG in the observation group were lower than those in the control group (P <0.01) (P <0.01). After treatment, the levels of FIB, DD and MPAR in the observation group were lower than those in the control group (P <0.01). After treatment, the levels of TNF-α, hs-CRP and IL-6 in the observation group were lower than those in the control group Control group (P <0.01). Conclusion: The therapeutic effect of Hu Shen Kang Fu Decoction adjuvant hormone on children with recurrent PNS is better than that of western medicine alone. The mechanism may be related to the reduction of inflammatory reaction, the regulation of lipid metabolism and the improvement of blood hypercoagulability.