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[摘要]
目的 探讨玉屏风颗粒联合他克莫司胶囊治疗儿童原发性肾病综合征的临床疗效。方法 选取2016年1月—2017年1月宜宾市第二人民医院收治的原发性肾病综合征患儿78例为研究对象,所有患儿按照随机数字表法分为对照组和治疗组,每组各39例。对照组餐前1~2 h口服他克莫司胶囊,0.10 mg/(kg∙d),2次/d,间隔12 h,诱导期为6个月,然后每3个月减量25%。治疗组在对照组基础上口服玉屏风颗粒,5 g/次,3次/d。两组患儿均连续治疗9个月。观察两组的临床疗效,比较两组的血清白蛋白、24 h尿蛋白和免疫指标。结果 治疗后,对照组和治疗组的总有效率分别为74.36%、92.31%,两组比较差异有统计学意义(P<0.05)。治疗后,两组白蛋白水平明显升高,24 h尿蛋白水平明显降低,同组治疗前后比较差异有统计学意义(P<0.05);且治疗组这些观察指标的改善程度明显优于对照组,两组比较差异有统计学意义(P<0.05)。治疗后,两组CD3+、CD4+、CD4+/CD8+、IgG、IgA水平均明显升高,同组治疗前后比较差异有统计学意义(P<0.05);且治疗组这些观察指标明显高于对照组,两组比较差异具有统计学意义(P<0.05)。结论 玉屏风颗粒联合他克莫司胶囊治疗儿童原发性肾病综合征具有较好的临床疗效,能改善患儿免疫功能,调节血清白蛋白和24 h尿蛋白的水平,安全性较好,具有一定的临床推广应用价值。
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[Abstract]
Objective To investigate the clinical efficacy of Yupingfeng Granules combined with Tacrolimus Capsules in treatment of primary nephrotic syndrome in children. Methods Children (78 cases) with primary nephrotic syndrome in the Second People's Hospital of Yibin from January 2016 to January 2017 were divided into control and treatment groups according to the random number table method, and each group had 39 cases. Patients in the control group were po administered with Tacrolimus Capsules, 0.10 mg/(kg∙d), twice daily. The interval was 12 h, the induction period was 6 months, and then every 3 months was reduced by 25%. Patients in the treatment group were po administered with Yupingfeng Granules on the basis of the control group, 5 g/time, three times daily. Patients in two groups were treated for 9 months. After treatment, the clinical efficacies were evaluated, and serum albumin, 24 h urine protein, and immune indexes in two groups were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 74.36% and 92.31%, respectively, and there was difference between two groups (P < 0.05). After treatment, the levels of serum albumin in two groups were significantly increased, but the levels of 24 h urine protein in two groups were significantly decreased, and the difference was statistically significant in the same group (P < 0.05). And the observational indexes in the treatment group were significantly better than those in the control group, with significant difference between two groups (P < 0.05). After treatment, the levels of CD3+, CD4+, CD4+/CD8+, IgG, and IgA in two groups were significantly increased, and the difference was statistically significant in the same group (P < 0.05). And the observational indexes in the treatment group were significantly higher than those in the control group, with significant difference between two groups (P < 0.05). Conclusion Yupingfeng Granules combined with Tacrolimus Capsules has clinical curative effect in treatment of primary nephrotic syndrome in children, can improve the immune function of children, regulate the levels of serum albumin and 24 h urine protein, with good safety, which has a certain clinical application value.
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