Objective:
To observe the
clinical efficacy of modified Zhibo Dihuangwan on
henoch-schonlein purpura nephritis with
deficiency of
liver and
kidney yin in
children (HSPN) and its effect on immune inflammatory response and hypercoagulable
state.
Method:
Totally 120
patients were randomly divided into
observation group (60 cases) and
control group (60 cases) by random number table.
Patients in two group was orally given
prednisolone acetate tablets, 1.5-2 mg·kg-1·d-1, 2 times. Four weeks later, the
drug was taken orally every other day, and the
dosage decreased gradually after 4 weeks. Besides,
patients in
control group was intravenously dripped with
cyclophosphamide, 8-12 mg·kg-1·d-1, for 2 days, and stopped for 2 weeks before another
treatment course. The
treatment lasted for 6 months. In the
control group,Dabuyin Wan was taken orally,3 g/
time,3 times/d.
Patients in
observation group was also added with modified Zhibo Dihuang Wan, 1 doe/day. The
treatment lasted for 6 months.
Urine routine was tested once a month, and disappearance
time and rate of
hematuria and
albuminuria were recorded. The 24 h
urine protein quantification, levels of microalbuminuria (mAlb) and urinary β2-microglobulin (β2-MG) were assessed before and
after treatment. Furthermore,
deficiency of
liver and
kidney Yin was scored, and levels of
T lymphocyte subsets (CD3+, CD4+, CD8+, CD4+/CD8+),
fibrinogen (FIB), D-dimer (D-D),
fibrin degradation products (FDP),
interleukin-2 (
IL-2),
interferon-γ (IFN-γ),
interleukin-4 (
IL-4),
interleukin-10 (
IL-10) were detected.
Result:
The
clinical efficacy in
observation group was superior to that in
control group (Z=2.078,P<0.05). Disappearance times of
hematuria and
albuminuria of
children in
observation group were shorter than those in
control group (P<0.01). The disappearance rate of
proteinuria in
observation group was 90.48%(38/42), which was higher than 69.77%(30/43) in
control group (χ2=5.694,P<0.05). The 24 h urinary
protein quantity, mAlb and levels of β2-MG, FIB, D-D and FDP in
observation group were lower than those in
control group (P<0.01). The levels of CD3+, CD4+,
IL-2 and IFN-γ and the ratio of CD4+/CD8+ in
observation group were higher than those in
control group (P<0.05), while the CD8+,
IL-4 and
IL-10 were lower than those in
control group (P<0.05). The
efficacy in
observation group was better than that in
control group (Z=2.106,P<0.05).
Conclusion:
In addition to conventional western
medicine therapy, modified Zhibo Dihuang Wan have an effect on HSPN with
deficiency of
liver and
kidney Yin in
children by promoting the disappearance of
albuminuria and
hematuria, shortening the
course of
disease, improving
T lymphocyte subpopulation, reducing inflammatory reaction and correcting hypercoagulable
state of
blood, with better
clinical efficacy and
syndrome effect of
traditional Chinese medicine.