复方丹参注射液联合环磷酰胺治疗儿童过敏性紫癜性肾炎的临床研究

目的 观察复方丹参注射液联合环磷酰胺治疗儿童过敏性紫癜性肾炎(HSPN)的临床疗效。方法 采用随机数字法将选取的100例HSPN患儿随机分为2组。对照组患儿采用环磷酰胺治疗,观察组患儿采用复方丹参注射液联合环磷酰胺治疗。分别将治疗前后2组患儿临床症状消失时间、肾功能指标(尿RBC、24hUpro、β2-MG、mALB)、凝血指标(PLT、FIB、PT、APPT、D-D)、炎性因子(TNF-α、TGF-β1)、基质金属蛋白酶(MMP-2及TIMP-2)、临床疗效进行比较。结果 观察组总有效率96.0%,高于对照组(82.0%,P<0.05);观察组患儿的临床症状消失时间、皮疹复发次数均明显少于对照组(P<0.05)。治疗后观察组患儿的尿β2-MG、RBC、mALB、24hUpro水平均显著降低(P<0.05),并且显著优于对照组(P<0.05)。治疗后观察组患儿血清TNF-α、TGF-β1、MMP-2、FIB、PLT、D-D水平显著降低(P<0.05),TIMP-2、PT、APPT水平显著升高(P<0.05),并且显著优于对照组(P<0.05)。观察组不良反应率为18.0%,对照组为24.0%,差异无统计学意义(P>0.05)。结论 环磷酰胺联合复方丹参注射液治疗儿童过敏性紫癜性肾炎临床疗效显著,并能有效调节机体的肾功能、凝血机制及炎性反应,对临床有指导意义。

Clinical study of compound salvia miltiorrhiza injection combined with cyclophosphamide in treatment of children with Henoch-Schonlein purpura nephritis

Objective To evaluate the clinical efficacy of cyclophosphamide combined with compound salvia miltiorrhiza injection in the treatment of children with Henoch-Schonlein purpura nephritis (HSPN). Methods From January 2016 to January 2018, 100 HSPN children were randomly divided into a control group and a trial group. The control group was given the compound salvia miltiorrhiza injection, and the trial group was given cyclophosphamide combined with compound salvia miltiorrhiza injection. The disappearance time of clinical symptoms, the renal function indexes, blood coagulation indexes, inflammatory factors and matrix metalloproteinase were investigated and the data were compared between two groups before and after the treatment. Results The total effective rate of the trial group was 96.0%, which was significantly higher than that of the control group (82.0%, P<0.05). The disappearance time of clinical symptoms and the frequency of skin purpura relapse of the trial group were shorter/less than those of the control group (P<0.05). After the treatment, the levels of urine β2-MG, RBC, mALB, and 24hUpro of the trial group were significantly lower than those before the treatment (P<0.05), and in addition, the changes of the trial group were significantly superior to those of the control group (P<0.05). After the treatment, the levels of serum TNF-alpha, TGF-beta 1, MMP-2, FIB, PLT, and D-D decreased significantly (P<0.05), but the levels of TIMP-2, PT, and APPT significantly increased (P<0.05), and the changes of the trial group were significantly superior to those of the control group. There was no significant difference between two groups in the adverse reactions (18.0% vs. 24.0%, P>0.05). Conclusion Cyclophosphamide combined with compound salvia miltiorrhiza injection in the treatment of children with HSPN has a good clinical effect, and can effectively regulate the body's renal function, coagulation mechanism and inflammatory response, which is of guiding significance to the clinic.