双肾汤调控小儿肾病综合征免疫力低下状态及对远期复发干预的临床研究

发布时间：2018-04-28 13:17

本文选题：免疫力低下状态 + 肾病复发　；参考：《成都中医药大学》2012年硕士论文

【摘要】：目的：通过观察具有温阳健脾、补肾填精的中药方剂双肾汤,调控小儿肾病综合征缓解期免疫力低下状态及其对复发的影响,探明中药调节小儿肾病免疫力低下状态的机理并拓宽中药在肾病综合征治疗过程中减少感染,防止复发的思路与路径。方法：总结古代医家对小儿肾病的认识,参考现代文献研究,结合导师临床经验,探讨肾病缓解期脾肾阳虚证与小儿肾病免疫力低下状态的相关性；以温阳健脾,补肾填精为法,运用双肾汤调控免疫力低下状态,并观察1年内肾病患儿的感染及复发情况。临床纳入60例病例,按照1：1比例分成治疗组与阳性对照组各30例。两组在小剂量激素治疗的基础上,治疗组口服双肾汤,对照组口服匹多莫德片,连续治疗8周。8周后两组比较进行中医症状、体液免疫的疗效评估,并通过调查随访,观察1年内肾病患儿的感染及复发情况,完成远期疗效评估。结果：(1)中医症状方面：治疗组和对照组治疗后组内比较均有统计学意义(p0.05)；治疗后组间比较,除面色改善差别不明显外,其余症状的改善治疗组优于对照组(p0.05)。(2)疾病疗效：治疗组显愈率93.3%；对照组显愈率83.3%,两组比较差异有统计学意义(p0.05)。(3)体液免疫指标：两组治疗后组内比较：IgG均有明显上升(p0.05),IgA、IgM改变不明显；治疗后两组间比较无统计学意义(p0.05)。(4)感染及肾病复发次数比较：1年内感染、复发次数,治疗组均少于对照组,差异有统计学意义(p0.05)。结论：双肾汤可以通过改善小儿肾病综合征缓解期免疫力低下状态,达到减少感染、预防复发的临床疗效,效果优于西药匹多莫德片,值得重视和做进一步深入的研究。
[Abstract]:Objective: to observe the effect of Shuangshen decoction, a traditional Chinese medicine prescription with tonifying kidney and tonifying kidney, on the immunity of children with nephrotic syndrome in remission period and its effect on relapse. To explore the mechanism of Chinese herbal medicine in regulating the immunosuppression of nephropathy in children and to broaden the thinking and path of reducing infection and preventing recurrence in the course of treatment of nephrotic syndrome with traditional Chinese medicine. Methods: to summarize the understanding of pediatric nephropathy by ancient physicians, refer to modern literature research, and combined with the clinical experience of tutor, to explore the correlation between deficiency of spleen and kidney yang in remission of nephropathy and low immunity state of children with nephropathy. The method of tonifying kidney and filling essence was used to regulate the state of immunosuppression and to observe the infection and recurrence of children with nephropathy within one year. Sixty cases were divided into treatment group (30 cases) and positive control group (30 cases) according to 1:1 ratio. On the basis of low dose hormone therapy, the treatment group was treated with Shuangshen decoction and the control group was treated with pidomod tablet. After 8 weeks of continuous treatment, the two groups were compared to evaluate the curative effect of traditional Chinese medicine (TCM) and humoral immunity, and were followed up by investigation. To observe the infection and recurrence in children with nephropathy within 1 year and to evaluate the long-term curative effect. Results (1) in terms of symptoms of traditional Chinese medicine, there were significant differences between the treatment group and the control group after treatment (P 0.05). The improvement of other symptoms in the treatment group was better than that in the control group (p0.05).) the curative effect of disease: the obvious recovery rate in the treatment group was 93.33.The obvious recovery rate in the control group was 83.3, the difference between the two groups was statistically significant. There was no significant change in IgA IgM. After treatment, there was no significant difference between the two groups in terms of infection and the number of recurrence of nephropathy: within one year, the number of recurrence in the treatment group was lower than that in the control group, and the difference was statistically significant (P 0.05). Conclusion: Shuangshen decoction can reduce infection and prevent recurrence by improving the state of immunity in remission stage of nephrotic syndrome in children, and the effect is better than that of pidomod tablet, which is worthy of further study.
【学位授予单位】：成都中医药大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R272

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