桂枝茯苓汤联合激素治疗小儿原发性肾病综合征疗效及对患者血清炎性因子的影响*

目的: 探讨桂枝茯苓汤联合激素治疗小儿原发性肾病综合征的疗效及对血清炎性因子的影响。方法: 选择70例小儿原发性肾病综合征患者为研究对象。采用随机数字表分组法将其分为对照组和观察组，各35例。所有患儿均给予抗感染、抗凝、利尿以及维持水电解质平衡等基础治疗。对照组患儿给予醋酸泼尼松片治疗，观察组在对照组基础上给予桂枝茯苓汤治疗。观察两组患者治疗前后24 h尿蛋白定量、ALB、hs-CRP、IL-13以及IL-6变化、临床疗效及生活质量情况。结果:治疗前两组患儿中医证候积分无明显差异（P＞0.05），治疗4、6、12个月后，两组患儿的中医证候积分均明显下降，且观察组比对照组下降更明显，差异具有统计学意义（P＜0.05）。两组治疗前24　h尿蛋白定量、ALB、hs-CRP、IL-13及IL-6水平比较差异无统计学意义（P>0.05）；治疗后24　h尿蛋白定量、hs-CRP、IL-13及IL-6水平均降低，ALB均升高（P<0.05），观察组治疗后24　h尿蛋白定量、hs-CRP、IL-13及IL-6水平均低于对照组，ALB高于对照组（P<0.05）；观察组有效率为94.29%（33/35）明显高于对照组74.29%（26/35，P<0.05）。两组治疗前生活质量评分比较差异无统计学意义（P>0.05）；两组治疗后生活质量评分显著升高，与治疗前比较差异有统计学意义（P<0.05）；观察组治疗后生活质量评分显著高于对照组，差异有统计学意义（P<0.05）。结论:桂枝茯苓汤联合激素可显著改善小儿原发性肾病综合征患儿高尿蛋白量及水肿等临床症状，降低血清hs-CRP、IL-13及IL-6等炎性因子水平，提高ALB水平，改善患儿生活质量水平。

Effect of Guizhi Fuling decoction combined with hormone on children with primary nephrotic syndrome and its influence on serum inflammatory factors

Objective :To investigate the curative effect of Guizhi Fuling decoction combined with hormone on children with primary nephrotic syndrome and its effect on serum inflammatory factors.Methods: 70 children with primary nephrotic syndrome admitted were selected as the research subjects. They were divided into control group and observation group by random number table grouping method, 35 cases in each group. All patients were given basic treatment such as anti infection, anticoagulation, diuresis and maintenance of water electrolyte balance. The control group was treated with prednisone acetate tablets, and the observation group was treated with Guizhi Fuling decoction on the basis of the control group. The changes of urinary protein, ALB, hs-CRP, IL-13 and IL-6, clinical efficacy and quality of life were observed before and after treatment.Results:There was no significant difference in TCM syndrome scores between the two groups before treatment (P> 0.05). After 4, 6 and 12 months of treatment, the TCM syndrome scores of the two groups were significantly decreased, and the observation group was more obvious than the control group, the difference was statistically significant (P< 0.05). There was no significant difference in the levels of 24h urine protein, ALB, hs-CRP, IL-13 and IL-6 before treatment (P>0.05). The quantitative of 24 h urine protein, hs-CRP, IL-13 and IL-6 water decreased after treatment, and ALB increased (P<0.05). The effective rate of observation group was 94.29% (33/35) and 74.29% (26/35) respectively (P< 0.05). There was no significant difference in the quality of life scores between the two groups (P>0.05); the quality of life in the two groups was significantly higher after treatment than before the treatment (P<0.05), and the quality of 〖LM〗life in the observation group was significantly higher than that in the control group (P<0.05).Conclusion:The combination of Guizhi Fuling decoction with hormone can significantly improve the clinical symptoms of high urine protein and edema in children with primary nephrotic syndrome, reduce the levels of serum hs-CRP, IL-13 and IL-6, improve the level of ALB, improve the quality of life of the children, use the drug safety, and be worthy of clinical application.