他克莫司联合槐杞黄颗粒对儿童原发性肾病综合征的疗效及对血清VEGF TGF-β_1 IL-1β IFN-γ的影响
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摘要
目的:研究他克莫司联合槐杞黄颗粒对儿童原发性肾病综合征的疗效及对血清血管内皮生长因子(VEGF)、转化生长因子、白细胞介素-1β(IL-1β)、干扰素-γ(IFN-γ)的影响。方法:选择2016年9月到2017年3月我院接诊收治的80例儿童原发性肾病综合征患儿,按抽签法分为对照组和实验组,每组40例。在都给予常规治疗的基础上,对照组采用他克莫司治疗,实验组采用他克莫司联合槐杞黄颗粒治疗,共治疗12周。观察并比较两组临床疗效,血清VEGF、、IL-1β、IFN-γ水平及不良反应发生情况。结果:治疗第4周,实验组浮肿消退时间、尿蛋白转阴时间明显短于对照组,差异有统计学意义(P<0.05);实验组血胆固醇含量略高于对照组,差异无统计学意义(P>0.05);实验组血白蛋白水平明显高于对照组,差异有统计学意义(P<0.05);治疗第12周,实验组有效率95.00%,高于对照组的77.50%,组间差异明显(P<0.05);实验组血白蛋白水平略高于对照组,差异无统计学意义(P>0.05)。治疗前,两组血清VEGF、、IL-1β、IFN-γ水平无差异(P>0.05);治疗后,两组血清VEGF、、IL-1β、IFN-γ水平均下降,实验组低于对照组,组间差异明显(P<0.05)。实验组总不良反应率15.00%,低于对照组的35.00%(P<0.05)。结论:他克莫司联合槐杞黄颗粒治疗儿童原发性肾病综合征的临床效果优,可有效降低患儿血清VEGF、、IL-1β、IFN-γ水平。
Objective: To study the efficacy of tacrolimus combined with Huaiqihuang granule in children with primary nephrotic syndrome and the effects of serum vascular endothelial growth factor(VEGF),transforming growth factor-β1(TGF-β1),interleukin 1β(IL-1β),interferon-γ(IFN-γ). Methods: From September 2016 to March 2017,80 children with primary nephrotic syndrome were selected and divided into control group and experimental group,40 cases in each group. On the basis of routine treatment,the control group was treated with tacrolimus,and the experimental group was treated with tacrolimus combined with Huaiqi Huang granules for 12 weeks. The clinical efficacy,serum levels of VEGF,TGF-beta 1,IL-1 beta,IFNgamma and adverse reactions were observed and compared between the two groups. Results: At the 4 th week,the time of edema subsided and urinary protein was shorter than that of the control group,the difference was statistically significant(P < 0. 05). The blood cholesterol level of the experimental group was slightly higher than that of the control group(P <0.05). At the 12 th week,the effective rate of the experimental group was95. 00%,which was higher than that of the control group(77.50%). The level of serum albumin in the experimental group was significantly higher than that in the control group(P <0.05). The level of serum albumin was slightly higher than that of the control group,the difference was not statistically significant(P >0.05). Before treatment,the levels of serum VEGF,TGF-β1,IL-1β and IFN-γ were not statistically significant(P >0.05). After treatment,the levels of serum VEGF,TGF-β1,IL-1β and IFN-γ were decreased in both groups(P<0.05). The difference between the two groups was significant(P<0.05). The total adverse reaction rate was 15.00% in the experimental group,which was lower than that in the control group,of which was 35.00%(P <0.05). Conclusion: The clinical effect of tacrolimus combined with Huaiqihuang granule in the treatment of children with primary nephrotic syndrome is better,which can effectively reduce the serum levels of VEGF,TGF-β1,IL-1β,IFN-γ level.
Objective: To study the efficacy of tacrolimus combined with Huaiqihuang granule in children with primary nephrotic syndrome and the effects of serum vascular endothelial growth factor(VEGF),transforming growth factor-β1(TGF-β1),interleukin 1β(IL-1β),interferon-γ(IFN-γ). Methods: From September 2016 to March 2017,80 children with primary nephrotic syndrome were selected and divided into control group and experimental group,40 cases in each group. On the basis of routine treatment,the control group was treated with tacrolimus,and the experimental group was treated with tacrolimus combined with Huaiqi Huang granules for 12 weeks. The clinical efficacy,serum levels of VEGF,TGF-beta 1,IL-1 beta,IFNgamma and adverse reactions were observed and compared between the two groups. Results: At the 4 th week,the time of edema subsided and urinary protein was shorter than that of the control group,the difference was statistically significant(P < 0. 05). The blood cholesterol level of the experimental group was slightly higher than that of the control group(P <0.05). At the 12 th week,the effective rate of the experimental group was95. 00%,which was higher than that of the control group(77.50%). The level of serum albumin in the experimental group was significantly higher than that in the control group(P <0.05). The level of serum albumin was slightly higher than that of the control group,the difference was not statistically significant(P >0.05). Before treatment,the levels of serum VEGF,TGF-β1,IL-1β and IFN-γ were not statistically significant(P >0.05). After treatment,the levels of serum VEGF,TGF-β1,IL-1β and IFN-γ were decreased in both groups(P<0.05). The difference between the two groups was significant(P<0.05). The total adverse reaction rate was 15.00% in the experimental group,which was lower than that in the control group,of which was 35.00%(P <0.05). Conclusion: The clinical effect of tacrolimus combined with Huaiqihuang granule in the treatment of children with primary nephrotic syndrome is better,which can effectively reduce the serum levels of VEGF,TGF-β1,IL-1β,IFN-γ level.
引文
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[2]王永霞.儿童原发性肾病综合征临床特征分析[J].中国卫生标准管理,2016,7(11):50~52.
[3]耿海云,曹力,王薇,等.槐杞黄颗粒治疗儿童原发性肾病综合征的前瞻性随机对照临床研究[J].中国当代儿科杂志,2015,17(1):31~34.
[4]中华医学会儿科学分会肾脏学组.儿童激素敏感、复发/依赖肾病综合征诊治循证指南(2016)[J].中华儿科杂志,2017,55(10):729~734
[5]刘俊朝,俞建,时毓民.肾病综合征患儿免疫功能的变化[J].中国中西医结合儿科学,2014,6(1):28~31.
[6]白丽春,覃远汉.免疫抑制剂在儿童难治性肾病综合征中的应用新进展[J].重庆医学,2015,44(19):2681~2684.
[7]汪年松,桂定坤,李军辉.他克莫司在肾脏病中的合理应用[J].中华肾病研究电子杂志,2014,3(4):200~203.
[8]张宏文,肖慧捷,姚勇.他克莫司治疗小儿肾病综合征致急性肾衰竭3例报告[J].临床儿科杂志,2017,35(6):409~411.
[9]刘运广,曹珊,林娜,等.槐杞黄颗粒联合泼尼松治疗儿童原发性肾病综合征疗效及对免疫功能影响的前瞻性随机对照研究[J].右江民族医学院学报,2017,39(3):163~167.
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