槐杞黃顆粒對(duì)過敏性紫癜性腎炎的療效觀察
發(fā)布時(shí)間：2019-04-15 20:07
【摘要】：目的：過敏性紫癜性腎炎（HSPN）是我國(guó)兒童時(shí)期常見的繼發(fā)性腎小球疾病之一，且其發(fā)病率有逐年增加的趨勢(shì)。其發(fā)病機(jī)制主要涉及到免疫系統(tǒng)紊亂，同時(shí)有細(xì)胞因子與炎癥介質(zhì)的參與，凝血與纖溶紊亂以及基因多態(tài)性改變也發(fā)揮著重要作用。本研究觀察具有免疫調(diào)節(jié)作用、滋腎潤(rùn)肺補(bǔ)肝等功能的槐杞黃顆粒對(duì)HSPN患兒的血清T細(xì)胞亞群（CD3+、CD4+、CD8+以及CD4/CD8+）、尿腎損傷分子-1（Kim-1）及尿P選擇素的影響，從而了解槐杞黃顆粒是否對(duì)過敏性紫癜性腎患兒的免疫功能、細(xì)胞因子及凝血系統(tǒng)等方面均有調(diào)節(jié)作用。 方法： 1研究對(duì)象及實(shí)驗(yàn)分組：選擇2010年11月至2011年10月在我院小兒腎臟內(nèi)科住院的符合目前國(guó)內(nèi)制定的HSPN診斷標(biāo)準(zhǔn)(2000年,珠海)的患兒54例，其中男35例，女19例，年齡3-14歲，根據(jù)HSPN的臨床表現(xiàn)分為：A組即少量蛋白尿和（或）血尿組，B組即大量蛋白尿組（大量蛋白尿即24小時(shí)尿蛋白定量≥50mg/kg）。將A組、B組按照隨機(jī)原則分別分A1（16例，男10例，女6例，平均年齡7.6歲）、B1（10例，，男7例，女3例，平均年齡8歲）為治療組，A2（18例，男11例，女7例，平均年齡7.4歲）、B2（10例，男7例，女3例，平均年齡7.9歲）為對(duì)照組。均為初治患兒，入院前未應(yīng)用激素及其它免疫抑制劑，除外入院前兩周曾用過腎毒性藥物者及各種原因引起的急慢性腎功能損害患兒。入院后A、B兩組均給予常規(guī)治療（包括潑尼松、維生素C、蘆丁、強(qiáng)溢、迪巧、腎炎康復(fù)片、抗感染等），在此基礎(chǔ)上，治療組加用槐杞黃顆粒，小于3歲，5g bid；大于3歲，10g bid；療程1個(gè)月。另設(shè)健康組15例，其中男7例，女8例，平均年齡6.8歲。選擇同期門診年齡、性別相匹配的健康體檢兒童，無風(fēng)濕、哮喘病史。 2檢測(cè)指標(biāo)及實(shí)驗(yàn)方法：采用流式細(xì)胞術(shù)測(cè)定T淋巴細(xì)胞亞群，用雙抗體夾心ABC-ELISA法測(cè)尿P選擇素和尿腎損傷分子-1的表達(dá)。各種指標(biāo)分別于入院后常規(guī)用藥治療前和用藥一個(gè)月之后檢測(cè)。所得數(shù)據(jù)采用SPSS13.0統(tǒng)計(jì)分析軟件進(jìn)行統(tǒng)計(jì)學(xué)處理，采用均數(shù)±標(biāo)準(zhǔn)差表示，臨床資料各組間統(tǒng)計(jì)學(xué)方法為t檢驗(yàn)和方差分析，以P0.05代表有顯著差異，P0.05為無顯著差異。 結(jié)果： 1A組、B組及健康組T細(xì)胞亞群測(cè)定值的比較 1.1A1、A2兩組患兒治療前CD3+、CD4+、CD8+與CD4/8+比較，差異無統(tǒng)計(jì)學(xué)意義(P0.05)。A1、A2兩組治療前與健康組比較，CD3+、CD4+差異均有統(tǒng)計(jì)學(xué)意義(P0.05)。兩組治療前后CD4+比較，差異有統(tǒng)計(jì)學(xué)意義(P0.05);兩組治療后比較,改善CD4+方面,治療組優(yōu)于對(duì)照組(P0.05)。A1組治療后與健康組比較，CD3+、CD4+、CD8+與CD4/8+差異均無統(tǒng)計(jì)學(xué)意義(P0.05)，而A2組治療后與健康組比較，CD3+、CD4+差異仍有統(tǒng)計(jì)學(xué)意義(P0.05)�？梢娭委熃M在改善血清CD3+、CD4+方面優(yōu)于對(duì)照組。 1.2B1、B2兩組患兒治療前CD3+、CD4+、CD8+與CD4/8+比較，差異無統(tǒng)計(jì)學(xué)意義(P0.05)。B1、B2兩組治療前與健康組比較，CD3+、CD4+、CD8+與CD4/8+差異均有統(tǒng)計(jì)學(xué)意義(P0.05)。兩組治療前后CD3+、CD8+比較，差異有統(tǒng)計(jì)學(xué)意義(P0.05)；兩組治療后比較,改善CD3+、CD8+方面，治療組優(yōu)于對(duì)照組(P0.05)。2A組、B組患兒尿腎損傷分子-1（Kim-1）測(cè)定值的比較 2.1A1、A2兩組患兒治療前尿Kim-1數(shù)值無統(tǒng)計(jì)學(xué)意義(P0.05)。這兩組患兒治療后與治療前相比，尿Kim-1數(shù)值均明顯降低，差異有統(tǒng)計(jì)學(xué)意義(P0.05)；這兩組患兒治療后尿Kim-1數(shù)值相比，A1組在降低尿Kim-1方面,優(yōu)于A2組(P0.05)。 2.2B1、B2兩組患兒治療前尿Kim-1數(shù)值無統(tǒng)計(jì)學(xué)意義(P0.05)。這兩組患兒治療后與治療前比較，尿Kim-1數(shù)值均明顯降低，差異有統(tǒng)計(jì)學(xué)意義(P0.05)；這兩組患兒治療后尿Kim-1測(cè)定值相比較，在保護(hù)腎臟方面，B1組優(yōu)于B2組(P0.05)。 3A組、B組患兒尿P選擇素測(cè)定值的比較 3.1A1、A2兩組患兒治療前尿P選擇素?cái)?shù)值無統(tǒng)計(jì)學(xué)意義(P0.05)。這兩組患兒治療后與治療前相比，尿P選擇素?cái)?shù)值均下降，差異有統(tǒng)計(jì)學(xué)意義(P0.05)；這兩組患兒治療后尿P選擇素測(cè)定值相比較，無統(tǒng)計(jì)學(xué)意義(P0.05)。 3.2B1、B2兩組患兒治療前尿P選擇素?cái)?shù)值無統(tǒng)計(jì)學(xué)意義(P0.05)。這兩組患兒治療后與治療前比較，尿P選擇素?cái)?shù)值均降低，差異有統(tǒng)計(jì)學(xué)意義(P0.05)；這兩組患兒治療后尿P選擇素測(cè)定值相比較，在活血方面，兩組無明顯差異(P0.05)。 結(jié)論：過敏性紫癜性腎炎患兒治療前存在T細(xì)胞免疫功能降低、紊亂，凝血與纖溶紊亂及腎臟損害�；辫近S顆粒不但能明顯改善T細(xì)胞免疫功能紊亂，還具有保護(hù)腎臟的作用，但對(duì)于改善凝血與纖溶紊亂作用不明顯�；辫近S顆粒副作用甚微，可作為HSPN治療的輔助藥物。
[Abstract]:Objective: Henoch-Schonlein purpura nephritis (HSPN) is one of the most common secondary glomerular diseases in childhood, and its incidence is increasing year by year. The pathogenesis of the invention is mainly related to the disorder of the immune system, and also plays an important role in the participation of the cytokines and the inflammatory mediators, the coagulation and the fibrinolysis and the change of the gene polymorphism. The effects of the anti-immune function, the nourishing of the kidney and the liver and the like on the serum T cell subpopulation (CD3 +, CD4 +, CD8 + and CD4/ CD8 +), the molecule-1 (Kim-1) and the urine P-selectin in children with HSPN were observed in this study. So as to know whether the pagodatree granules have a regulating effect on the immune function, the cytokine and the blood coagulation system of the allergic purpura renal children. square Method:1 study object and experimental group:54 cases of children with renal internal medicine in our hospital from November 2010 to October 2011 were selected according to the current standard of HSPN diagnosis (2000, Zhuhai). Among them,35 were male,19 were female, and 3-3 in age. The clinical manifestations of HSPN were divided into two groups: A group, a small amount of proteinuria and/ or a hematuria group, and a large number of proteinuria groups in group B (a large amount of proteinuria,24-hour urine protein, and 50 mg/ kg), according to the clinical manifestations of HSPN. Kg). group A and group B were divided into A1 (16 cases, male 10 cases, female 6 cases, mean age 7.6 years), B1 (10 cases, male 7 cases, female 3 cases, average age 8 years) as treatment group, A2 (18 cases, male 11 cases, female 7 cases, average age 7.4years), B2 (10 cases, male 7 cases) according to the random principle. 3 cases (mean age: 7.9 years) were women. The control group received no hormone and other immunosuppressants before the admission, except for the acute and chronic renal failure caused by the renal toxicity drug and various causes in the first two weeks of the admission. The two groups after admission were treated with routine treatment (including prednisone, vitamin C, rutin, strong overflow, diaoqiao, nephritis rehabilitation, anti-infection, etc.). In one month, there were 15 healthy groups, including 7 males and 8 females, with an average age of 6 .8-year-old. Choose a healthy child with the same age and gender in the same period of the same period. History of asthma. detection index and experimental method: using flow cytometry to measure T lymphocyte subpopulation, and using double antibody sandwich ABC-ELISA to measure urine P-selectin and urine-kidney injury molecule. -1. The various indices were before and after the routine treatment before admission. After the month, the data was measured by SPSS 13.0. The statistical method of the clinical data was t-test and variance analysis, and the difference between the two groups was P0.05. No significant Difference. Results: Group 1A, group B, and healthy group T The difference of CD3 +, CD4 +, CD8 + and CD4/8 + in the two groups was not significant (P0.05). Compared with the healthy group, the CD3 + and CD4 + differences were both in series. The difference of CD4 +, CD4 +, CD8 + and CD4/8 + in the treatment group was higher than that in the control group (P0.05). The difference of CD3 + and CD4 + in the treatment of A2 group compared with that in the healthy group, and the difference between CD3 + and CD4 + was still in series. In the treatment group, the serum CD3 + was improved. The difference of CD3 +, CD4 +, CD8 + and CD4/8 + in the two groups was significantly higher than that in the control group. The difference of CD3 + and CD8 + in the two groups was statistically significant (P0.05), and the treatment group was better than that of the control group (P0.05). 1(Kim- 1) Comparison of the measured values 2.1 A1 and A2 two groups of children in the treatment of urine Kim-1 There was no significant difference in the number of urinary Kim-1 in the two groups (P0.05). On the other hand, it was superior to that of the A2 group (P0.05). -1. There was no significant difference between the two groups (P0.05). The surface and B1 group were superior to the B2 group (P0.05). Comparison of the measurement of urinary P-selectin in group 3A and group B, and the treatment of the two groups in group A and A2 There was no significant difference in the value of P-selectin in the two groups (P0.05). The values of the two groups were not significant (P0.05). There was no significant difference in the value of the P-selectin in the two groups (P0.05). The values of the P-selectin in the two groups were lower and the difference was significant (P <0.05). The value of the P-selectin in the two groups was measured. In comparison, there was no significant difference between the two groups in the aspect of blood circulation (P0.05). Conclusion: The pre-treatment of the children with Henoch-Schonlein purpura nephritis The immune function of T cell is reduced, the disorder, the coagulation and the fibrinolysis, and the kidney damage. The pagodatree granule not only can obviously improve the immune function of the T cell, but also has the function of improving the immune function of the T cell, The effect of the kidney is protected, but the effect of improving the coagulation and the fibrinolysis is not obvious.
【學(xué)位授予單位】：河北醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2012
【分類號(hào)】：R272
本文編號(hào)：2458453
[Abstract]:Objective: Henoch-Schonlein purpura nephritis (HSPN) is one of the most common secondary glomerular diseases in childhood, and its incidence is increasing year by year. The pathogenesis of the invention is mainly related to the disorder of the immune system, and also plays an important role in the participation of the cytokines and the inflammatory mediators, the coagulation and the fibrinolysis and the change of the gene polymorphism. The effects of the anti-immune function, the nourishing of the kidney and the liver and the like on the serum T cell subpopulation (CD3 +, CD4 +, CD8 + and CD4/ CD8 +), the molecule-1 (Kim-1) and the urine P-selectin in children with HSPN were observed in this study. So as to know whether the pagodatree granules have a regulating effect on the immune function, the cytokine and the blood coagulation system of the allergic purpura renal children. square Method:1 study object and experimental group:54 cases of children with renal internal medicine in our hospital from November 2010 to October 2011 were selected according to the current standard of HSPN diagnosis (2000, Zhuhai). Among them,35 were male,19 were female, and 3-3 in age. The clinical manifestations of HSPN were divided into two groups: A group, a small amount of proteinuria and/ or a hematuria group, and a large number of proteinuria groups in group B (a large amount of proteinuria,24-hour urine protein, and 50 mg/ kg), according to the clinical manifestations of HSPN. Kg). group A and group B were divided into A1 (16 cases, male 10 cases, female 6 cases, mean age 7.6 years), B1 (10 cases, male 7 cases, female 3 cases, average age 8 years) as treatment group, A2 (18 cases, male 11 cases, female 7 cases, average age 7.4years), B2 (10 cases, male 7 cases) according to the random principle. 3 cases (mean age: 7.9 years) were women. The control group received no hormone and other immunosuppressants before the admission, except for the acute and chronic renal failure caused by the renal toxicity drug and various causes in the first two weeks of the admission. The two groups after admission were treated with routine treatment (including prednisone, vitamin C, rutin, strong overflow, diaoqiao, nephritis rehabilitation, anti-infection, etc.). In one month, there were 15 healthy groups, including 7 males and 8 females, with an average age of 6 .8-year-old. Choose a healthy child with the same age and gender in the same period of the same period. History of asthma. detection index and experimental method: using flow cytometry to measure T lymphocyte subpopulation, and using double antibody sandwich ABC-ELISA to measure urine P-selectin and urine-kidney injury molecule. -1. The various indices were before and after the routine treatment before admission. After the month, the data was measured by SPSS 13.0. The statistical method of the clinical data was t-test and variance analysis, and the difference between the two groups was P0.05. No significant Difference. Results: Group 1A, group B, and healthy group T The difference of CD3 +, CD4 +, CD8 + and CD4/8 + in the two groups was not significant (P0.05). Compared with the healthy group, the CD3 + and CD4 + differences were both in series. The difference of CD4 +, CD4 +, CD8 + and CD4/8 + in the treatment group was higher than that in the control group (P0.05). The difference of CD3 + and CD4 + in the treatment of A2 group compared with that in the healthy group, and the difference between CD3 + and CD4 + was still in series. In the treatment group, the serum CD3 + was improved. The difference of CD3 +, CD4 +, CD8 + and CD4/8 + in the two groups was significantly higher than that in the control group. The difference of CD3 + and CD8 + in the two groups was statistically significant (P0.05), and the treatment group was better than that of the control group (P0.05). 1(Kim- 1) Comparison of the measured values 2.1 A1 and A2 two groups of children in the treatment of urine Kim-1 There was no significant difference in the number of urinary Kim-1 in the two groups (P0.05). On the other hand, it was superior to that of the A2 group (P0.05). -1. There was no significant difference between the two groups (P0.05). The surface and B1 group were superior to the B2 group (P0.05). Comparison of the measurement of urinary P-selectin in group 3A and group B, and the treatment of the two groups in group A and A2 There was no significant difference in the value of P-selectin in the two groups (P0.05). The values of the two groups were not significant (P0.05). There was no significant difference in the value of the P-selectin in the two groups (P0.05). The values of the P-selectin in the two groups were lower and the difference was significant (P <0.05). The value of the P-selectin in the two groups was measured. In comparison, there was no significant difference between the two groups in the aspect of blood circulation (P0.05). Conclusion: The pre-treatment of the children with Henoch-Schonlein purpura nephritis The immune function of T cell is reduced, the disorder, the coagulation and the fibrinolysis, and the kidney damage. The pagodatree granule not only can obviously improve the immune function of the T cell, but also has the function of improving the immune function of the T cell, The effect of the kidney is protected, but the effect of improving the coagulation and the fibrinolysis is not obvious.
【學(xué)位授予單位】：河北醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2012
【分類號(hào)】：R272
【參考文獻(xiàn)】
相關(guān)期刊論文 前10條
1 崔天盆,巫學(xué)蘭,吳健民;甲型肝炎病毒受體的研究進(jìn)展[J];國(guó)外醫(yī)學(xué).臨床生物化學(xué)與檢驗(yàn)學(xué)分冊(cè);2004年06期
2 唐華;鄒平;李著華;;腎損傷分子-1研究進(jìn)展[J];國(guó)際檢驗(yàn)醫(yī)學(xué)雜志;2006年08期
3 劉厚奇;樓方岑;孔憲濤;;淋巴細(xì)胞組胺受體與免疫調(diào)節(jié)[J];國(guó)外醫(yī)學(xué)(免疫學(xué)分冊(cè));1988年02期
4 霍文謙;張克勤;靳風(fēng)爍;;腎損傷分子-1與腎小管損傷研究進(jìn)展[J];重慶醫(yī)學(xué);2010年19期
5 王娟莉;黃燕萍;;細(xì)胞因子與紫癜性腎炎研究進(jìn)展[J];中國(guó)婦幼健康研究;2008年02期
6 李洪娟;王新良;;過敏性紫癜凝血活性分子標(biāo)志物研究進(jìn)展[J];實(shí)用兒科臨床雜志;2007年09期
7 陳蓉燕;于力;;兒童過敏性紫癜和紫癜性腎炎的治療新進(jìn)展[J];醫(yī)學(xué)綜述;2008年14期
8 姜紅;羅鋼;姜紅X;李維;;過敏性紫癜腎損害的分析及診斷指標(biāo)的評(píng)價(jià)[J];中國(guó)醫(yī)科大學(xué)學(xué)報(bào);2006年04期
9 中華醫(yī)學(xué)會(huì)兒科學(xué)分會(huì)腎臟病學(xué)組;紫癜性腎炎的診斷與治療(草案)[J];中國(guó)實(shí)用兒科雜志;2003年03期
10 張波;倪寧;吳玉斌;;原發(fā)性腎病綜合征患兒槐杞黃顆粒治療前后血清細(xì)胞因子變化的研究[J];中國(guó)實(shí)用兒科雜志;2010年01期
本文編號(hào)：2458453
本文鏈接：http://sikaile.net/yixuelunwen/eklw/2458453.html
最近更新
教材專著
