本文選題：腎病綜合征 + 醋酸潑尼松片��； 參考：《遼寧中醫(yī)雜志》2017年02期

【摘要】：目的:探討健脾利濕補(bǔ)腎法對(duì)小兒腎病綜合征(NS)骨代謝、體質(zhì)量及生長發(fā)育的影響。方法:選取2012年6月—2014年6月醫(yī)院收治的NS患兒66例作為研究對(duì)象,辨證為脾虛濕困型,采用隨機(jī)數(shù)字表法分為對(duì)照組和觀察組,各33例。對(duì)照組給予醋酸潑尼松片治療,觀察組在對(duì)照組基礎(chǔ)上給予健脾化濕方治療,4周為1個(gè)療程,共治療3個(gè)療程。評(píng)估臨床療效,對(duì)主癥狀進(jìn)行量化評(píng)分,檢測(cè)血清白蛋白、24 h尿蛋白定量、血清骨鈣素N端中分子片段(骨鈣素N-MID)、骨鈣素(BGP)、甲狀腺旁激素(PTH)、骨特異性堿性磷酸酶(BALP);門診和電話隨訪1年,了解兩組身高和體質(zhì)量(BMI)變化情況,記錄復(fù)發(fā)率及復(fù)發(fā)次數(shù)。結(jié)果:觀察組治療有效率為93.94%,與對(duì)照組的84.85%比較,差異無統(tǒng)計(jì)學(xué)意義(P0.05);觀察組治療后全身浮腫、面色萎黃、納少便溏、乏力評(píng)分低于對(duì)照組(P0.05);觀察組治療后血清白蛋白、骨鈣素N-MID、BGP高于對(duì)照組,24 h蛋白定量、PTH、BALP低于對(duì)照組。兩組治療后1年身高、BMI較治療前升高(P0.05),但治療后1年組間比較無差異(P0.05);觀察組1年復(fù)發(fā)率為21.21%明顯低于對(duì)照組的48.48%(P0.05);觀察組1年平均復(fù)發(fā)次數(shù)少于對(duì)照組(P0.05)。結(jié)論:健脾利濕補(bǔ)腎法輔助治療小兒NS可有效緩解臨床癥狀,改善骨代謝異常,但對(duì)患兒生長發(fā)育無明顯影響。
[Abstract]:Objective: to study the effect of invigorating spleen and dampness and tonifying kidney on bone metabolism, body weight and growth and development of NSN in children with nephrotic syndrome. Methods: 66 cases of NS were selected from June 2012 to June 2014. The syndrome differentiation was spleen deficiency and dampness. The patients were divided into control group (33 cases) and observation group (33 cases) by random digital table. The control group was treated with prednisone acetate and the observation group was treated with Jianpi Huazheng recipe for 4 weeks. To evaluate the clinical efficacy, to evaluate the main symptoms, and to measure the serum albumin 24 h urine protein quantification. Serum osteocalcin N-terminal molecular fragments (osteocalcin N-MIDP, osteocalcin (BGP), parathyroid hormone (PTH), bone specific alkaline phosphatase (BALP) were followed up for one year to investigate the changes of height and body mass of BMIs in the two groups, and the recurrence rate and recurrence times were recorded. Results: the effective rate of treatment in the observation group was 93.94, and there was no significant difference between the observation group and the control group (84.85%), there was no significant difference between the observation group and the control group (P 0.05), the observation group had systemic swelling, yellow complexion, loose stool and low feces, and the score of fatigue was lower than that of the control group (P 0.05), and the serum albumin after treatment in the observation group was lower than that in the control group. BGP of osteocalcin N-MIDN was significantly higher than that of control group (P < 0.01). One year after treatment, the body mass index (BMI) of the two groups was higher than that before treatment, but there was no difference between the two groups one year after treatment, the recurrence rate of one year in the observation group was 21.21% significantly lower than that in the control group, and the average recurrence times in the observation group was less than that in the control group (P 0.05). Conclusion: the method of invigorating spleen and dampness and tonifying the kidney can effectively relieve clinical symptoms and improve abnormal bone metabolism in children with NS, but it has no obvious effect on the growth and development of children.
【作者單位】： 武漢市兒童醫(yī)院;
【分類號(hào)】：R272

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