健脾利湿补肾法对小儿肾病综合征骨代谢、体质量及生长发育的影响

发布时间：2018-05-17 14:35

本文选题：肾病综合征 + 醋酸泼尼松片　；参考：《辽宁中医杂志》2017年02期

【摘要】：目的:探讨健脾利湿补肾法对小儿肾病综合征(NS)骨代谢、体质量及生长发育的影响。方法:选取2012年6月—2014年6月医院收治的NS患儿66例作为研究对象,辨证为脾虚湿困型,采用随机数字表法分为对照组和观察组,各33例。对照组给予醋酸泼尼松片治疗,观察组在对照组基础上给予健脾化湿方治疗,4周为1个疗程,共治疗3个疗程。评估临床疗效,对主症状进行量化评分,检测血清白蛋白、24 h尿蛋白定量、血清骨钙素N端中分子片段(骨钙素N-MID)、骨钙素(BGP)、甲状腺旁激素(PTH)、骨特异性碱性磷酸酶(BALP);门诊和电话随访1年,了解两组身高和体质量(BMI)变化情况,记录复发率及复发次数。结果:观察组治疗有效率为93.94%,与对照组的84.85%比较,差异无统计学意义(P0.05);观察组治疗后全身浮肿、面色萎黄、纳少便溏、乏力评分低于对照组(P0.05);观察组治疗后血清白蛋白、骨钙素N-MID、BGP高于对照组,24 h蛋白定量、PTH、BALP低于对照组。两组治疗后1年身高、BMI较治疗前升高(P0.05),但治疗后1年组间比较无差异(P0.05);观察组1年复发率为21.21%明显低于对照组的48.48%(P0.05);观察组1年平均复发次数少于对照组(P0.05)。结论:健脾利湿补肾法辅助治疗小儿NS可有效缓解临床症状,改善骨代谢异常,但对患儿生长发育无明显影响。
[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.
【作者单位】：武汉市儿童医院;
【分类号】：R272

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