槐杞黄颗粒治疗儿童紫癜性肾炎临床疗效及对免疫功能的影响

目的观察槐杞黄颗粒治疗儿童紫癜性肾炎的临床疗效及其对患儿免疫功能的影响。方法选取山西省儿童医院肾内科收治的紫癜性肾炎患儿120例为研究对象,按照随机数字表法分为常规综合治疗的对照组和联合槐杞黄颗粒治疗的观察组,每组各60例。2组均连续治疗随访6个月,并于治疗后1年进行回访。观察2组患儿临床治疗效果,治疗前后血白蛋白、血肌酐、尿红细胞、尿蛋白及免疫功能的变化、治疗过程中药物的不良反应及回访时的复发情况。结果观察组治疗总有效率91.6%,明显高于对照组78.3%(P<0.05);治疗后观察组尿微量白蛋白、尿蛋白定量(24 h)及尿沉渣红细胞计数水平均明显低于对照组(P<0.01);观察组IgA、IgE水平均低于对照组(P<0.01);观察组外周血CD8+水平下降,CD3+、CD4+及CD4+/CD8+水平均上升,观察组改善更显著(P<0.01)。观察组治疗后1年的复发率低于对照组(P<0.05)。结论联合槐杞黄颗粒治疗可有效缓解紫癜性肾炎患儿临床症状,改善免疫功能,降低临床复发率,且无明显不良反应,具有良好的临床应用价值。

Clinical efficacy of Huaiqihuang Granules and its effect on immune function in children with purpura nephritis

Objective To investigate the clinical efficacy of Huaiqihuang(HQH)Granules and its effect on immune function in children with purpura nephritis.Methods A total of 120 children with purpura nephritis admitted to the Department of Nephrology,Shanxi Provincial Children′s Hospital,were included in this study.According to random number table,they were divided into a control group on usual comprehensive treatment and a study group given comprehensive treatment and HQH Granules(n=60 each).The both groups were followed up for the six-month treatment,and a return visit was scheduled at one year after treatment.The treatment efficacy,changes in blood albumin,creatinine,urinary red blood cell,urinary protein and immune function before and after treatment,adverse drug reactions during the treatment and recurrence up to the return visit were recorded.Results The total rate of response in the study group was 91.6%,which was significantly higher than 78.3%in the control group(P<0.05).After treatment,the study group showed significantly lower levels of urinary microalbumin,24h urinary total protein,and urinary red blood cells,compared with the control group(P<0.01).The IgA and IgE levels were lower in the study group than those in the control group(P<0.01).The both group showed lower CD8+level and higher levels of CD3+,CD4+and CD4+/CD8+in the peripheral blood,compared with baseline;such improvements were more eminent in the study group(P<0.01).At one year after treatment,there was less recurrence in the study group than that in the control group(P<0.05).Conclusion Addition of HQH Granules in the treatment may effectively ameliorate the clinical symptoms,improve immune function,reduce clinical recurrence,and meanwhile is with no obvious adverse reactions,in children with purpura nephritis.This could be valuable in clinical practice.