黄芪地黄汤对小儿过敏性紫癜肾炎的治疗作用

目的：观察黄芪地黄汤治疗小儿过敏性紫癜肾炎（HSPN）的临床疗效和治疗前后患儿血清对大鼠肾小球系膜细胞（rGMC）增殖的影响及IL-6、TNF-α水平变化。方法：收集HSPN 80例，随机分成两组，西医组40例，中西医结合组40例（西医组用药基础上加用黄芪地黄汤），并建立正常儿童对照组30例。用药组治疗疗程均为3个月。疗程结束后，观察患儿缓解率并测定患儿血清IL-6、TNF-α水平，观察治疗前后患儿血清对rGMC增殖的影响。结果：治疗前，西医组、中西医结合组的IL-6、TNF-α水平与正常儿童对照组比较均明显上升（P〈0.05或P〈0.01）。3个月疗程后，中西医结合组总缓解率为87．5％，西医组疗效总缓解率为60％，二组差异有显著性（P〈0.05）；中西医结合组IL-6水平基本降至正常，与正常对照组相比差异无显著性（P〉0.05），TNF-α水平有下降，西医组IL-6及TNF-α水平仅略有下降，与正常对照组相比差异有显著性（P〈0.05及P〈0.01）。与正常对照组血清体外培养rGMC的OD值相比，治疗前西医组、中西医结合组均有增高（P〈0.05），治疗后中西医结合组无差别，而西医组差异有显著性（P〈0.05）。结论：中西医结合治疗可更有效地下调IL-6、TNF-α水平，减少系膜细胞增殖，黄芪地黄汤的疗效可能与减轻系膜细胞增殖有关。

Therapeutic effect of HQDHT on children with Henoch-Schoenlein purpura nephritis

Objective： To observe the curative effect of HQDHT on chilren with Henoch-Schoenlein Purpura Nephritis （HSPN）,and to observe the serum levels of IL-6 and TNF-α in the patients after HQDHT treatment and investigate the effect of the patient＇s serum after treatment on the proliferation of rat glomerular mesangial cell （rGMC）. Methods： Eighty cases with HSPN were collected, and then divided into two groups equally： group 1 （western medicine group） and group 2 （Western medicine with HQDHT group）,the control group was composed of 30 normal children. The course of treatment was 3 months, then compared to the total alleviated rate of the group 1 and group 2, and the patient＇ s serum levels of IL-6 and TNF-α were measured. The proliferation of rGMC was investigated. Results： Compared with the control group, the level of IL-6 and TNF-α significantly up-regulate in group 1 and group 2 before the treatment （P〈0.05 and P〈0.01 ）. After 3 month＇s treatment courses,the total alleviated rate of group 1 was 60%,and that of group 2 was 87.5% （P〈0.05）. The level of IL-6 in group 2 basically descended to normal （P〉0.05）, the level of TNF-α in group 2 and IL-6,TNF-α in group 1 were only slightly decreased,there also was statistically significance compared with the control group （P〈0.05 or P〈0.01）. Before treatment, the OD value of rGMC proliferation in group 1 and group 2 were statistically increased than that in the control group （P〈0.05）. After treatment,there was no significant difference between group 2 and the control group （P〉0.05）,while there was statistically significance between group 1 and the control group （P〈0.05）. Conclusion： Western medicine with HQDHT can more effectively downregulate the serum level of IL-6 and TNF-α, reduce the proliferatian of GMC, the mechanism of curative effect with HQDHT may relate to the reduction of the proliferation of GMC.