火把花根片治疗儿童过敏性紫癜肾炎的临床研究

作者	单位
周建华	华中科技大学同济医学院附属同济医院儿科武汉 430030
黄爱霞	华中科技大学同济医学院附属同济医院儿科武汉 430030
刘铜林	华中科技大学同济医学院附属同济医院儿科武汉 430030
唐锦辉	华中科技大学同济医学院附属同济医院儿科武汉 430030
匡裕玖	华中科技大学同济医学院附属同济医院儿科武汉 430030

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中文摘要:

目的探讨火把花根片对儿童过敏性紫癜肾炎(Henoch-Schonlein purpura nephritis,HSPN)综合征型和肾病综合征型的治疗作用,并与雷公藤多甙片进行对比研究。方法 82例儿童HSPN,分为雷公藤多甙片和火把花根片治疗组,肾炎型单独应用雷公藤多甙片或火把花根片治疗,肾病型分别联合泼尼松口服,6个月后观察两组疗效及尿蛋白、尿视黄醇结合蛋白(retinal-binding protein,RBP)、尿N-乙酰β-D氨基葡萄糖苷酶(N-acetyl-beta-glucosaminidase,NAG)等相关指标变化。结果火把花根片组肾炎型完全缓解率58.8％,部分缓解率为41.2％,雷公藤多甙片组完全缓解率、部分缓解率和无效率分别为20.8％、66.7％和12.5％。两组结果比较,差异有显著性(P<0.05,P<0.01)。火把花根片组肾病型完全缓解率高于雷公藤多甙片组,但差异无显著性(P>0.05)。两组均能显著降低HSPN患儿尿蛋白、尿RBP和NAG水平,肾炎型火把花根片治疗组6个月时尿蛋白量低于雷公藤多甙片治疗组,差异有显著性(P<0.05)。结论火把花根片对儿童HSPN肾炎型和肾病型及肾小管-间质的病变均有显著疗效,其对HSPN肾炎型降尿蛋白效果及总疗效好于雷公藤多甙片。

英文摘要:

To study the effect of Colquhounia root tablet (CRT) in treating childhood Henoch-Schonlein purpura nephritis (HSPN) and compared with tripterygium wilfordii multiglycoside tablet (TWMGT). Methods Eighty-two children with HSPN were divided into the CRT group and the control group. To patients of nephritic type, treatment with CRT and TWMGT was applied separately, but to those of nephrotic type, the treatment was given together with prednisone. Therapeutic effect and changes of related indexes, including urinary protein, retinal-binding protein (RBP), N-acetyl-β-glucosaminidase (NAG), were observed after patients received treatment for 6 months. Results The complete remission (CR) rate and partial remission (PR) rate in patients of nephritic type in the treated group was 58. 8% and 41. 2% respectively, while those in the control group was 20.8% and 66.7% respectively, and the ineffective rate being 12.5% . Comparison of the therapeutic effect between the two groups showed significant difference (P<0.05). Although the CR rate in patients of nephrotic type in the treated group was higher than that in the control group, the difference was insignificant (P>0.05). The urinary levels of protein, RBP and NAG lowered in both groups, but level of urinary protein in the treated group of nephritic type after 6 months of treatment was significantly lower than that in the control group (P < 0.05). Conclusion CRT shows obvious effect in improving childhood HSPN of nephritic type, nephrotic type and attenuating the tubulointerstitial lesions, compared with TWMGT, CRT is more effective in lowering proteinuria and better in total effective rate.

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