氦氖激光穴位照射结合雷公藤多甙治疗儿童难治性肾病

目的：探讨氦氖激光穴位照射结合雷公藤多甙治疗儿童难治性肾病的效果及作用机制。方法：将59例患儿按就诊顺序随机分为两组,两组患儿治疗前均正规使用过或正在使用激素,对照组单纯加服雷公藤多甙治疗,治疗组在对照组基础上以HN8-4型氦氖激光治疗仪进行穴位照射治疗,疗程均为10个月。随访3年,记录复发情况。结果：治疗组临床总有效率90.0%,对照组76.8%,两组比较P〈0.05。重复肾活检定量分析显示：治疗组肾小球病变活动指数（GAI）显著降低,对照组变化较小,肾小管间质慢性化病变指数（TI）治疗组下降,对照组不变。间质病变活动指数（VAI）治疗组下降,对照组变化不大。结论：氦氖激光穴位照射结合雷公藤多甙治疗儿童难治性肾病的临床疗效显著,无痛苦,并能明显改善肾脏病理改变,是一种有效的治疗儿童难治性肾病的方法。

Study of the curative effect of tripterygium wilfordii combined with helium neon laser acupoint irradiation in refractory nephrotic syndrome

Objective:To study the curative effect of tripterygium wilfordii combined with helium neon(He-Ne)laser acupoint irradiation in the treatment of refractory nephrotic syndrome(RNS)and its mechanism of action.Methods:Fifty-nine sick children with refractory nephrotic syndrome were randomly divided into two groups.The control group(n=29)was only treated with tripterygium wilfordii,while the treatment group(n=30)with He-Ne laser acupoint irradiation and tripterygium wilfordii,the course of treatment was 10 months in both groups.The curative effects were observed and compared before and after treatment,and the repetitive renal biopsy was performed in 41 patients after 12 months of treatment.The pathologic changes were analysed with scion image B software.Results:The total effective rate was 90.0% in the treatment group,obviously superior to 76.8% in the control group(P<0.05).The repetitive quantitative analysis of renal biopsy showed that all the glomerular active index(GAI),tubular interstitial index(TI)and vascular activ index(VAI)in the treatment group decreased after treatment compared with those in the control group,but without statistical difference.Conclusion:Tripterygium wilfordii combined with He-Ne laser acupoint irradiation is effective in patients with refractory nephrotic syndrome.It is a convenient painless and highly effective method.