肾康灵对儿童频复发性肾病患儿血浆神经肽Y的影响

目的 观察中药肾康灵对小儿频复发性肾病(FRNS)患儿的治疗作用及机制.方法 将FRNS患儿60例随机分为中药肾康灵十西药治疗组(中西药组)30例、西药对照组(西药组)30例,并选取30例健康体检儿童为健康对照组,两组患儿均口服泼尼松1.5～2.0mg/(kg·d),分3次口服,用至4～8周或尿蛋白转阴后2周,改为隔日顿服;继用4周后逐渐减量,每2～4周减2.5～5.0mg,减量至能维持缓解的最小有效激素量,隔日口服,总疗程约12～18个月.泼尼松部分效应或无效应的患儿,均加服免疫抑制剂如环孢素A或霉酚酸酯,疗程共约6个月；中西药组在开始治疗时加用中药肾康灵煎剂,水煎服,每日1剂,泼尼松停药后继续服用2个月.检测两组患儿治疗前和治疗3个月后及健康对照组外周血浆神经肽Y(NPY),同时观察两组患儿治疗前和治疗3个月后24h尿蛋白定量、血浆白蛋白(Alb)、胆固醇(CH)、甘油三酯(TG)等指标.结果 两组患儿治疗前NPY含量明显高于健康对照组(P＜0.01).治疗后与治疗前比较,两组患儿血NPY均显著降低(P＜0.05或P＜0.01)；治疗后中西药组NPY降低更为明显(P＜0.05).与治疗前比较,治疗后两组患儿血CH、TG和24h尿蛋白水平均显著降低(P＜0.01),血浆Alb水平显著升高(P＜0.01)；治疗后中西药组血CH、TG和24h尿蛋白均较西药明显降低(P＜0.05或P＜0.01),血Alb升高(P＜0.05). 结论 FRNS患儿表现为NPY显著升高,中药肾康灵治疗FRNS能显著降低患儿的NPY,其作用机制可能通过调节FRNS患儿NEI网络功能而发挥整体调节作用.

Effect of Shenkangling Decoction on Neuropetide Y in Frequent Relase Nehritic Syndrome in Children

Objective To observe the effect and mechanism of Shen kangling Decoction(decoction for nephrosis) on frequent relase nehritic syndrome(FRNS).Methods Sixty children suffered from FRNS were randomized into two groups,western medication combined with Chinese medication group and only western medication group,with 30 in ea ch.Thirty healthy children were adopted as healthy control group.Both groups of patients we re taken prednisone orally for 12 to 18 months.Other immunosuppressant was give n to the ineffective cases after using prednisone.The treatment course lasted f or 6 months.Shenkangling Decoction was added in the combined treatment group.Neuropeptide(NPY),24-hour urinary protein(24h-UP),Albumin(Alb),cholesterol(CH) and triglyceride(TG) were observed before the treatment and after 3 months of treament.Results Comparing with the healthy control group C,NPY were significantly increased in FRNS children(P<0.01).After treatment,NPY were significantly decreased in both groups(P <0.05 or P<0.01),especially in combined treatment group(P<0.05).The levels of cholestero l,TG and 24h-UP decreased while the level of Alb increased significantly in both treated groups after treatment(P<0.01),especially in the combined treatment group(P<0.05 or P<0.01).Conclusion NPY is significantly increased in FRNS children.Shenk angling Decoction could significantly reduce the level of NPY in FRNS children,which maybe relevant to regulating the homeostasis,