肾炎康复片联合激素治疗儿童紫癜性肾炎的临床疗效及安全性分析
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摘要
目的分析肾炎康复片联合糖皮质激素治疗儿童紫癜性肾炎的临床疗效及安全性。方法 2018年1月至11月河北大学附属医院收治的80例紫癜性肾炎患儿为实验对象,依据入院先后顺序分为对照组(n=39)、观察组(n=41), 2组患儿均开展抗过敏等相关对症治疗,对照组给予糖皮质激素治疗,观察组在对照组的基础上给予肾炎康复片治疗,对比2组患儿的临床效果、临床症状消退时间、 24 h尿蛋白定量、血清IgA水平及不良反应。结果对照组和观察组比较临床疗效差异有统计学意义(Z=1.688,P=0.046);与对照组比较,观察组患儿的临床症状消退时间较短(P<0.05);治疗前,与对照组比较,观察组患儿的24 h尿蛋白定量及血清IgA水平差异无统计学意义(P>0.05);治疗后,与对照组比较,观察组患儿的24 h尿蛋白定量及血清IgA水平改善明显;与对照组不良反应发生率(20.51%)比较,实验组(2.45%)较低(P<0.05)。结论针对紫癜性肾炎患儿在糖皮质激素治疗的基础上给予肾炎康复片治疗,在提升治疗效果的同时减少不良反应,改善24 h尿蛋白定量、血清IgA水平,缩短临床症状消退时间。
ObjectiveTo analyze the clinical efficacy and safety of Shenyankangfupian combined with glucocorticoid in the treatment of children with Henoch-Sch?nlein purpura nephritis.Methods80 children with HenochSch?nlein purpura nephritis admitted to Affiliated Hospital of Hebei University from January 2018 to November2018 were divided into control group(n= 39) and observation group(n= 41) according to the order of admission. The patients of the two groups were given symptomatic treatment such as antiallergy, the patients in thecontrol group were given glucocorticoid therapy, and the patients in the observation group were given Shenyankangfupian on the basis of the control group, and the treating. results of the two groups were compared. The clinical effect, clinical symptoms subsidence time, urinary protein excretion in 24-hour collections, serum IgA andadverse reactions of the patients were examined.ResultsThere was statistically significant difference between thecontrol group and the observation group in the clinical effect(Z= 1. 688,P= 0. 046). Compared with the control group, the clinical symptom regression time of the observation group was shortened(P<0. 05). Before treatment, compared with the control group, there was no statistically significant difference in the urinary protein excretion in 24-hour collections and serum IgA level of the observation group(P>0. 05). After treatment, compared with the control group, the urinary protein excretion in 24-hour collections and serum IgA level of the observation group were significantly improved. Compared with the control group(20. 51%), the incidence of adverse reactions in the experimental group(2. 45%) was reduced(P<0. 05).ConclusionShenyankangfupiangiven to children with HenochSch?nlein purpura nephritis on the basis of glucocorticoid therapy can improve thetherapeutic effect and reduce adverse reactions, improve urinary protein excretion in 24-hour collections and serum IgA shorten the time of clinical symptoms subsidence.
ObjectiveTo analyze the clinical efficacy and safety of Shenyankangfupian combined with glucocorticoid in the treatment of children with Henoch-Sch?nlein purpura nephritis.Methods80 children with HenochSch?nlein purpura nephritis admitted to Affiliated Hospital of Hebei University from January 2018 to November2018 were divided into control group(n= 39) and observation group(n= 41) according to the order of admission. The patients of the two groups were given symptomatic treatment such as antiallergy, the patients in thecontrol group were given glucocorticoid therapy, and the patients in the observation group were given Shenyankangfupian on the basis of the control group, and the treating. results of the two groups were compared. The clinical effect, clinical symptoms subsidence time, urinary protein excretion in 24-hour collections, serum IgA andadverse reactions of the patients were examined.ResultsThere was statistically significant difference between thecontrol group and the observation group in the clinical effect(Z= 1. 688,P= 0. 046). Compared with the control group, the clinical symptom regression time of the observation group was shortened(P<0. 05). Before treatment, compared with the control group, there was no statistically significant difference in the urinary protein excretion in 24-hour collections and serum IgA level of the observation group(P>0. 05). After treatment, compared with the control group, the urinary protein excretion in 24-hour collections and serum IgA level of the observation group were significantly improved. Compared with the control group(20. 51%), the incidence of adverse reactions in the experimental group(2. 45%) was reduced(P<0. 05).ConclusionShenyankangfupiangiven to children with HenochSch?nlein purpura nephritis on the basis of glucocorticoid therapy can improve thetherapeutic effect and reduce adverse reactions, improve urinary protein excretion in 24-hour collections and serum IgA shorten the time of clinical symptoms subsidence.
引文
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[4]李志娟,李俊,黄惠梅,等.霉酚酸酯联合糖皮质激素治疗小儿紫癜性肾炎的疗效观察[J].现代生物医学进展,2017,17(26):5177-5180.DOI:10.13241/j.cnki.pmb.2017.26.041.
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[9]阿迪力江·喀日,扎依旦·艾力,罗燕飞,等.环磷酰胺联合强的松治疗儿童肾病综合征型紫癜性肾炎的疗效观察[J].新疆医科大学学报,2016,39(11):1416-1419.DOI:10.3969/j.issn.1009-5551.2016.11.017.
[10]姜敏,万廷信,李建华.肾炎康治疗IgA肾病76例的临床疗效[J].中药药理与临床,2015,31(2):185-186.DOI:10.13412/j.cnki.zyyl.2015.02.102.
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[12]周波.肾炎康联合依那普利治疗老年糖尿病肾病疗效评估报道[J].医学信息,2015,36(41):235-236.DOI:10.3969/j.issn.1006-1959.2015.41.339.
[13]张桂月,王凤君,关美玉.肾炎康联合依那普利对老年糖尿病肾病的治疗价值探讨[J].中国实用医药,2016,11(11):130-131.DOI:10.14163/j.cnki.11-5547/r.2016.11.095.
[14]朱辟疆,解冰,江丽萍.肾炎康对大鼠系膜增生性肾炎MCP-1的影响[J].浙江中西医结合杂志,2007,17(11):665-667.DOI:10.3969/j.issn.1005-4561.2007.11.003.
[15]叶婷婷,王黎萍,沈建明,等.肾炎康复片对肾间质纤维化大鼠基质金属蛋白酶-9/金属蛋白酶组织抑制物-1表达的影响[J].山西医药杂志,2012,41(18):900-901.DOI:10.3969/j.issn.0253-9926.2012.18.007.
[16]丁云峰,李志辉,段翠蓉,等.肾炎康治疗小儿紫癜性肾炎血尿和蛋白尿的疗效观察[J].中国中西医结合儿科学,2017(5):39-41.DOI:10.3969/j.issn.1674-3865.2017.05.013.
[2]SCOTT C,MCCULLOCH M,NOURSE P.Takayasus arteritis in children:a developing world perspective[J].Annals of Paediatric Rheumatology,2013,2(2):1.DOI:10.5455/apr.120320130832.
[3]CHEN A C,LIN C L,SHEN T C,et al.Association between allergic diseases and risks of Henoch-Sch?nlein purpura(HSP)and HSP nephritis:a population-based study[J].Pediatric Research,2016,79(4):559-564.DOI:10.1038/pr.2015.271.
[4]李志娟,李俊,黄惠梅,等.霉酚酸酯联合糖皮质激素治疗小儿紫癜性肾炎的疗效观察[J].现代生物医学进展,2017,17(26):5177-5180.DOI:10.13241/j.cnki.pmb.2017.26.041.
[5]刘永平.雷公藤联合肾炎康治疗紫癜性肾炎30例疗效观察[J].中国伤残医学,2015,23(3):171-172.DOI:10.13214/j.cnki.cjotadm.2015.03.137.
[6]朱春华,黄松明.紫癜性肾炎诊治循证指南(2016)解读[J].中华儿科杂志,2017,55(9):654-657.DOI:10.3760/cma.j.issn.0578-1310.2017.09.003.
[7]CHEN J Y,MAO J H.Henoch-Sch(?)nlein purpura nephritis in children:incidence,pathogenesis and management[J].World Journal of Pediatrics,2015,11(1):29-34.DOI:10.1007/s12519-014-0534-5.
[8]MAO Y,YIN L,XIA H,et al.Incidence and clinical features of paediatric vasculitis in Eastern China:14-year retrospective study,1999-2013[J].Journal of International Medical Research,2016,44(3):710-717.DOI:10.1177/0300060515621446.
[9]阿迪力江·喀日,扎依旦·艾力,罗燕飞,等.环磷酰胺联合强的松治疗儿童肾病综合征型紫癜性肾炎的疗效观察[J].新疆医科大学学报,2016,39(11):1416-1419.DOI:10.3969/j.issn.1009-5551.2016.11.017.
[10]姜敏,万廷信,李建华.肾炎康治疗IgA肾病76例的临床疗效[J].中药药理与临床,2015,31(2):185-186.DOI:10.13412/j.cnki.zyyl.2015.02.102.
[11]靳晓明,杨尧,孙世辉,等.基于数据挖掘中医治疗儿童过敏性紫癜辨证和用药规律[J].医学研究与教育,2018,35(3):39-43.DOI:10.3969/j.issn.1674-490X.2018.03.007.
[12]周波.肾炎康联合依那普利治疗老年糖尿病肾病疗效评估报道[J].医学信息,2015,36(41):235-236.DOI:10.3969/j.issn.1006-1959.2015.41.339.
[13]张桂月,王凤君,关美玉.肾炎康联合依那普利对老年糖尿病肾病的治疗价值探讨[J].中国实用医药,2016,11(11):130-131.DOI:10.14163/j.cnki.11-5547/r.2016.11.095.
[14]朱辟疆,解冰,江丽萍.肾炎康对大鼠系膜增生性肾炎MCP-1的影响[J].浙江中西医结合杂志,2007,17(11):665-667.DOI:10.3969/j.issn.1005-4561.2007.11.003.
[15]叶婷婷,王黎萍,沈建明,等.肾炎康复片对肾间质纤维化大鼠基质金属蛋白酶-9/金属蛋白酶组织抑制物-1表达的影响[J].山西医药杂志,2012,41(18):900-901.DOI:10.3969/j.issn.0253-9926.2012.18.007.
[16]丁云峰,李志辉,段翠蓉,等.肾炎康治疗小儿紫癜性肾炎血尿和蛋白尿的疗效观察[J].中国中西医结合儿科学,2017(5):39-41.DOI:10.3969/j.issn.1674-3865.2017.05.013.