摘要
目的探讨黄葵胶囊联合吗麦替考酚酯治疗儿童IgA肾病的临床疗效及对血清BUN、Scr含量的影响。方法选取医院2016年1月—2020年12月期间收治的92例患有IgA肾病的儿童作为研究对象,采用随机平均的方法将其分为观察组和对照组,每组46例。其中对照组患儿采用吗替麦考酚酯治疗,而观察组患儿在此基础上采用中药黄葵胶囊进行治疗,对比分析两组患儿的临床疗效、血清BUN、Scr和其他各生化指标,以及T淋巴细胞亚群。结果观察组患者中完全缓解的比例为43.47%(20/46),总有效率为95.65%(44/46),均显著高于对照组的21.73%(10/46),80.43%(37/46)(均P<0.05)。经过治疗后,观察组患儿的BUN、SCr及其他生化检测项目均明显比对照组好(P<0.05)。两组患儿的T淋巴细胞亚群CD_(4)^(+)、CD_(3)^(+)和CD_(4)^(+)/CD_(8)^(+)均显著高于治疗前,而CD_(8)^(+)与治疗前相比,稍有下降;其中观察组患儿治疗后的T细胞各亚群的改善水平均显著优于对照组(P<0.05)。经过治疗后,观察组的IgA、IgG和IgM均明显高于对照组患儿(P<0.05)。经过治疗后,两组患儿的血清IFN-γ和IL-6含量均明显下降(P<0.05),且观察组患儿含量均明显低于对照组(P<0.05)。两组患儿的尿NAG和β2-MG含量均明显降低(P<0.05),且观察组患儿含量明显低于对照组(P<0.05);经过治疗后,两组患儿的尿沉渣红细胞的数量均明显下降(P<0.05),且观察组患儿含量明显低于对照组(P<0.05)。在治疗的过程中,对照组患儿发生1例恶心,1例皮疹,2例腹泻,1例瘙痒,1例头晕,其不良反应的发生率为13.04%;而观察组患儿出现1例腹泻,其不良反应的发生率为2.17%;经统计分析,观察组患儿不良反应的发生率明显低于对照组,具有显著性差异(χ^(2)=4.667,P<0.05)。结论黄葵胶囊联合吗麦替考酚酯治疗儿童IgA肾病具有较好的临床疗效,可改善其血清IgA、IgG和IgM水平,以及患儿的SCr和BUN等各种检测指标,且对T细胞亚群有较佳的临床功效。
Objective To investigate the clinical efficacy of Huangkui Capsule(黄葵胶囊)combined with mycophenolate mofetil in the treatment of IgA nephropathy in children and its effect on the contents of blood urea nitrogen(BUN)and serum creatinine(SCR).Methods Ninety-two children with IgA nephropathy treated in the hospital from January 2016 to December 2020 were selected as the research object.They were randomly divided into observation group and control group,with 46 cases in each group.The children in the control group were treated with mycophenolate mofetil,while those in the observation group were treated with Huangkui Capsule.The clinical efficacy,levels of BUN,SCR and other biochemical indexes as well as T lymphocyte subsets of the two groups were compared and analyzed.Results the proportion of complete remission in the observation group was 43.47%(20/46),and the total effective rate was 95.65%(44/46),which were significantly higher than 21.73%(10/46)and 80.43%(37/46)in the control group(all P<0.05).After treatment,the levels of BUN,SCR and other biochemical tests in the observation group were significantly better than those in the control group(P<0.05).T lymphocyte subsets CD_(4)^(+),CD_(3)^(+) and CD_(4)^(+)/CD_(8)^(+) in the two groups were significantly higher than those before treatment,while CD_(8)^(+) decreased slightly compared with those before treatment.The improvement level of T cell subsets in the observation group was significantly better than that in the control group(P<0.05).After treatment,the levels of IgA,IgG and IgM in the observation group were significantly higher than those in the control group(P<0.05).After treatment,the serum levels of interferon-γ(IFN-γ)and IL-6 of the two groups decreased significantly(P<0.05),and the levels in the observation group were significantly lower than those in the control group(P<0.05).The levels of N-acetyl-β-D-glucosaminidase(NAG)andβ2-MG in urine in the observation group were significantly lower than those in the control group(P<0.05).After treatment,the number of urinary sediment red blood cells in the two groups decreased significantly(P<0.05),and that in the observation group was significantly lower than that in the control group(P<0.05).In the course of treatment,1 case of nausea,1 case of rash,2 cases of diarrhea,1 case of pruritus and 1 case of dizziness occurred in the control group.The incidence of adverse reactions was 13.04%.One case of diarrhea occurred in the observation group,and the incidence of adverse reactions was 2.17%.Through statistical analysis,the incidence of adverse reactions in the observation group was significantly lower than that in the control group(χ^(2)=4.667,P<0.05).Conclusion Huangkui Capsule combined with mycophenolate mofetil has a good clinical effect in the treatment of children with IgA nephropathy.It can improve the levels of serum IgA,IgG and IgM,as well as various detection indexes such as SCR and BUN,and has a better clinical effect on T cell subsets.
作者
郑鑫
王华玲
马坤
陈琅
缪长新
陈贤娥
ZHENG Xin;WANG Hualing;MA Kun;CHEN Lang;MIAO Changxin;CHEN Xian'e(Fujian Medical University Provincial Clinical College,Fuzhou 350122,Fujian,China;Fujian Provincial Hospital,Fuzhou 350001,Fujian,China;The First Operating Room,Provincial Clinical College,Fujian Medical University,Fuzhou 350122,Fujian,China;Department of Pediatrics,Shouning County Hospital,Ningde 355500,Fujian,China)
出处
《中华中医药学刊》
CAS
北大核心
2022年第12期230-234,共5页
Chinese Archives of Traditional Chinese Medicine
基金
福建省卫生健康科技计划(2020GGB004)。
关键词
黄葵胶囊
吗麦替考酚酯
儿童IGA肾病
临床疗效
T细胞亚群
Huangkui Capsule(黄葵胶囊)
mycophenolate mofetil
IgA nephropathy in children
clinical efficacy
T cell subsets
