目的 探讨复方肾炎片联合环磷酰胺治疗儿童过敏紫癜性肾炎的临床疗效。方法 选取2020年2月—2021年2月河南中医药大学第一附属医院收治的98例过敏紫癜性肾炎患儿，按照随机数字表法将所有患者分为对照组和治疗组，每组各49例。对照组口服环磷酰胺片，2~6 mg/kg，1次/d。治疗组在对照组治疗基础上口服复方肾炎片，3片/次，3次/d。两组连续治疗7 d。观察两组的临床疗效，比较两组症状缓解时间、肾功能指标和血清因子。结果 治疗后，治疗组总有效率是97.96%，显著高于对照组的79.59%（P<0.05）。治疗后，治疗组皮肤紫癜、关节疼痛、腹痛、血尿缓解时间均显著短于对照组（P<0.05）。治疗后，两组尿红细胞、24 h尿蛋白定量（24 h Upro）、尿微量白蛋白（mALB）均显著降低（P<0.05）；治疗后，治疗组肾功能指标改善优于对照组（P<0.05）。治疗后，两组患者白细胞介素-4（IL-4）、转化生长因子-β1（TGF-β1）、基质金属蛋白酶2（MMP-2）、肿瘤坏死因子α（TNF-α）水平均较治疗前显著降低（P<0.05）；治疗后，治疗组血清因子水平显著低于对照组（P<0.05）。结论 复方肾炎片联合环磷酰胺治疗儿童过敏紫癜性肾炎具有较好的临床疗效，可有效改善患儿症状，改善炎症反应，降低蛋白尿与血尿水平，具有一定的临床推广应用价值。

Objective To investigate the therapeutic effect of Compound Shenyan Tablets combined with cyclophosphamide in treatment of allergic purpura nephritis in children. Methods A total of 98 children with allergic purpura nephritis admitted to the First Affiliated Hospital of Henan University of Traditional Chinese Medicine from February 2020 to February 2021 were selected. According to the random number table method, all patients were divided into control group and treatment group, with 49 cases in each group. Patients in the control group were po administered with Cyclophosphamide Tablets, 2-6 mg/kg, once daily. Patients in the treatment group were po administered with Compound Shenyan Tablets on the basis of the control group, 3 tablet/time, three times daily. Patients in two groups were treated for 7 d. After treatment, the clinical efficacy was evaluated, and symptom relief time, renal function indexes and serum factors were compared between the two groups. Results After treatment, the total effective rate of the treatment group was 97.96%, significantly higher than 79.59% of the control group (P < 0.05). After treatment, the relief time of skin purpura, joint pain, abdominal pain, and hematuria in treatment group was significantly shorter than that in control group (P < 0.05). After treatment, urine erythrocyte, 24 h urine protein quantitation (24 h Upro) and urine microalbumin (mALB) in two groups were significantly decreased (P < 0.05); After treatment, the renal function index of the treatment group improved better than that of the control group (P < 0.05). After treatment, the levels of interleukin-4 (IL-4), transforming growth factor -β1 (TGF-β1), matrix metalloproteinase 2 (MMP-2) and tumor necrosis factor α (TNF-α) in two groups were significantly decreased compared with before treatment (P < 0.05). After treatment, the level of serum factor in treatment group was significantly lower than that in control group (P < 0.05). Conclusion Compound Shenyan Tablets combined with cyclophosphamide has good clinical efficacy in treatment of allergic purpura nephritis in children, and can effectively improve the symptoms of children, improve inflammatory response, reduce proteinuria and hematuria levels, which has a certain clinical application value.

R985

河南省医学科技攻关计划项目（LHGJ20200656）