健脾益气法治疗小儿频复发肾病综合征35例临床观察

目的观察健脾益气法治疗小儿频复发肾病综合征的临床疗效,初步探讨其作用机制。方法将72例频复发肾病综合征患儿随机分为2组,对照组采用常规西医治疗,治疗组在此基础上加用健脾益气法治疗,比较2组的复发次数、尿β2-微球蛋白(β2-MG)、免疫球蛋白(Ig A,IgG)、血浆胆固醇及血浆皮质醇、复发后尿蛋白转阴时间及完全缓解时间。结果治疗组1年复发次数、尿β2-MG、血浆胆固醇均低于对照组(P<0.05);免疫球蛋白和血浆皮质醇高于对照组(P<0.05);复发后治疗组尿蛋白转阴时间短于对照组,完全缓解时间长于对照组,差异均有统计意义(P<0.05)。结论健脾益气法参与小儿频复发肾病综合征的治疗具有较好的临床效果,其机制可能与改善免疫功能、提高肾上腺皮质功能、改善高脂血症等多种途径密切相关。

Clinical observation of 35 cases of infantile frequent relapse nephrotic syndrome treated with strengthening the spleen and replenishing qi

Objective To observe the clinical effect of invigorating spleen and replenishing qi on frequently relapse nephrotic syndrome of children,and explore its mechanism. Methods 72 children with frequently relapse nephrotic syndrome were randomly divided into 2 groups,the control group was only given western medicine,the treatment group was treated additionally with invigorating spleen and replenishing qi. Compare the relaps times,renal tubular function,immunoglobulin,plasma cholesterol,plasma cortisol,urine protein positive duration,and complete alleviate duration. Results The treatment group was lowed in relapse times in a year,β2-microglobulin and plasma cholesterol than control group; but immunoglobulin and plasma cortisol of the treatment group was higher than that of the control group. The recurrent treatment group,urine protein positive duration was shorter than that of recurrent control group,and complete alleviate duration was longer than that of control group. There was significant difference between the 2 groups（P〈0. 05）. Conclusion The treatment of invigorating spleen and replenishing qi involved in the therapy of frequently relapse nephrotic syndrome of children has good clinical effect.The mechanism may be related to the improvement of immune function,the function of adrenal cortex,and lowering of hyperlipidemia.