中西医链接治疗小儿肾病综合征生活质量评价

目的:本课题以小儿肾病综合征(NS)为靶点,通过观察西医及中西医治疗后对其生活质量的影响,初步评价两种方案的有效性和安全性及生命质量,以期建立中西链接治疗儿科肾病规范化方案及生活质量评价系统。方法:收集来源于2011年7月—2012年6月1年间四川省人民医院,符合原发型小儿肾病综合征的诊断及纳入标准的病人,经排除标准筛选的入选病例作为受试对象,根据随机的原则,按1∶1比例随机纳入中西医组与西医组,共纳入120例,中西医组60例,西医组60例,以中西医组作为治疗组,西医组作为对照组。对照组用西医治疗方案进行,治疗组在对照组基础上分阶段加用中医药链接治疗。治疗组自身前后及治疗组与对照组治疗后在生活质量方面进行比较。结果:(1)治疗组痊愈26例(43.3%)、显效18例(30%)、有效10例(6.67%),总有效率90%;对照组痊愈18例(30%)、显效15例(25%)、有效12例(20%),总有效率75%。治疗组与对照组比较:Z=-2.674,P=0.0060.05,说明在疾病疗效方面,治疗组优于对照组,结果有显著性差异。(2)治疗前与治疗后比较,治疗组与对照组主症均有好转,积分均减少,P0.05,均有显著性差异;说明两组治疗均有效。治疗组与对照组治疗后比较,除浮肿P=0.2430.05,无显著性差异外,蛋白尿、血尿、血浆白蛋白、胆固醇比较均P0.05,有显著性差异;说明治疗组与对照组在改善浮肿方面疗效相当,无明显差异;但在治疗蛋白尿、血尿血浆白蛋白、胆固醇方面治疗组明显优于对照组。(3)治疗组与对照组治疗前生活质量积分比较均P0.05,无统计学意义,说明治疗组与对照组的生活质量具有可比性。(4)治疗组与对照组治疗后生活质量积分比较:Z=-4.324,P=0.0360.05,说明在生活质量改善方面,治疗组优于对照组,结果有显著性差异。结论:中西医链接方案治疗小儿肾病综合征疗效确切,明显优于单纯西药组。可以减少复发次数,降低对身高、体重生理方面的影响,从而显著提高患儿生活质量。

Evaluation on Traditional Chinese and Western Medicine Treatment of Life Quality of Pediatric Nephrotic Syndrome

Objective ： Taking children with nephrotie syndrome （ NS ） as the target and through the observation of western medicine and traditional Chinese and western medicine treatment effect on the quality of life to evaluate the efficacy and safety of the two plans and quality of life and to establish a link between Chinese and western treatment of pediatric nephrotie syndrome standardization and quality of life evaluation system. Methods：Patients From Sichuan Province People＇s Hospital during July 2011 to June 2012 who conformed to pediatric nephrotic syndrome were selected. Based on the principle of random, according to 1 ： 1 proportion, they were randomly into traditional Chinese and western medicine group and western medicine group,60 cases in each. Chinese and western medicine was as a treatment group and western medicine as control group. The control group was treated with western medicine treatment and the treatment group added TCM treatment. Before and after treatment, qualities of life in two groups were compared. Results ： （ 1 ） In the treatment group： 26 cases recovered （ 43.3% ）, 18 cases were markedly improved （ 30% ）, 10 cases were effective （ 6.67% ）, the total effective rate was 90%. In control group, 18 cases were cured （ 30% ）, 15 cases were markedly improved （ 25% ）, 12 cases were effective （ 20% ）, the total effectiverate was 75%. The treatment group compared with control group ： Z=2.674, P=0.006〈0.05. The results showed that in terms Of disease curative effect, the treatment group was better than control group and had significant differences.（ 2 ） Compared the result before and after treatment, the treatment group and control group＇s primary symptoms were improved and integral scores were reduced, P〈0.05. Both groups had significant difference and both treatments were effective. Treatment group compared with control group after treatment： except edema had no significant difference （ P=0.243〉0.05 ）; proteinuria, hematuria, plasma albumin and cholesterol had significant difference （ P〈0.05 ） ： Treatment group and control group in improving dropsy curative effect had no obvious difference. But in the treatment of proteinuria, hernaturia plasma albumin and cholesterol, treatment group was better than control group. （ 3 ） The quality of life scare in the treatment group and control group before treatment both had no statistical significance （P〉0.05）, indicating that the treatment group and control group on the quality of life were comparable. （ 4 ） The treatment group and control group after treatment＇s quality of life scores had significant difference （ Z=4.324, P=0.036〈0.05 ）. The treatment group was better than control group in quality of life and the results had significant difference. Conclusion ： Traditional Chinese and western medicine treatment of children with nephrotic syndrome is superior to pure western medicine. It can reduce the recurrence rate, the influence on height, weight and physiological aspects so as to improve the quality of life in children.