天津医药

天津医药 ›› 2017, Vol. 45 ›› Issue (1): 54-57.doi: 10.11958/20160184

• 临床研究 • 上一篇    下一篇

ACTH 和槐杞黄治疗频复发肾病综合征患儿的疗效观察 #br# #br#

王文红1,张碧丽2,刘艳1,刘妍1,赵林胜3   

  1. 1 天津市儿童医院肾内科 （邮编 300134）； 2 天津医科大学研究生院


  • 收稿日期:2016-03-21 修回日期:2016-09-02 出版日期:2017-01-15 发布日期:2017-01-15
  • 基金资助:
    天津市中医药管理局中医、中西医结合科研专项课题

The effects of ACTH and Huaiqihuang on the treatment of recurrence nephrotic syndrome in children

WANG Wen-hong1, ZHANG Bi-li1, LIU Yan1, LIU Yan1, ZHAO Lin-sheng1; YANG Li-xiao2 #br# #br#   

  1. 1 Department of Nephrology, Tianjin Children’ s Hospital, Tianjin 300134,China; 2 Graduate School, Tianjin Medical University

  • Received:2016-03-21 Revised:2016-09-02 Published:2017-01-15 Online:2017-01-15

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摘要： 摘要： 目的 观察促肾上腺皮质激素 （ACTH） 联合槐杞黄对频复发肾病综合征 （FRNS） 患儿的疗效及安全性。方 法 55 例 FRNS 患儿分为糖皮质激素 （GC） 维持治疗的对照组 （A 组， 10 例）、 槐杞黄组 （B 组， 17 例）、 ACTH 组 （C 组， 14 例）和 ACTH 联合槐杞黄组（联合治疗组， D 组， 14 例）， 连续治疗 12 个月。分别记录治疗 6 个月和 12 个月时各 组 GC 使用量、 肾上腺皮质基础分泌水平及肾上腺皮质储备水平， 同时记录各组患儿复发率及不良反应情况。结果 治疗 6 个月后， C、 D 组的 GC 用量明显低于 A、 B 组 （P < 0.05）， A~D 组肾上腺皮质储备水平依次升高 （P < 0.05）。治 疗 12 个月后， C、 D 组与 A、 B 组相比较， GC 用量降低， 肾上腺皮质基础分泌水平和储备水平均升高 （P < 0.05）， 而 C、 D 组间上述指标差异无统计学意义（P > 0.05）。在治疗 6 个月和 12 个月后， C、 D 组患儿复发率均低于 A、 B 组（P < 0.05）。结论 单纯应用 ACTH 以及联合槐杞黄均可减轻 FRNS 患儿长期服用 GC 对下丘脑-垂体-肾上腺轴的抑制作用。

关键词: 肾病综合征, 肾上腺皮质激素类, 糖皮质激素类, 氢化可的松, 皮质醇, 槐杞黄, 下丘脑-垂体-肾上腺轴

Abstract: Abstract：Objective To observe the effects and safety of adrenocorticotropic hormone (ACTH) combined with Huaiqihuang on frequent relapse nephrotic syndrome (FRNS) in children. Methods Fifty-five child patients with FRNS were divided into control group, which was given glucocorticoid (GC) to maintain the treatment (group A, n=10), Huaiqihuang group (group B, n=17), ACTH group (group C, n=14) and ACTH combined with Huaiqihuang group (combined treatment group, group D, n=14). Continuous treatment was for 12 months. The GC treatment doses, the levels of basal secretion of adrenal cortex and adrenal cortex reserve were recorded at 6-month and 12-month respectively. And the recurrence rate and adverse reactions were observed in four groups. Results After 6-month treatment, the doses of GC were significantly lower in group C and group D than those in group A and group B (P < 0.05). The levels of basal secretion of adrenal cortex were increased in turn in group A~D (P < 0.05). After 12-month treatment, the doses of GC were significantly decreased in group C and group D than those in group A and group B, while the level of basal secretion of adrenal cortex and adrenal cortex reserve were increased (P < 0.05). There were no significant differences in the doses of GC between group C and group D (P > 0.05). After treatment for 6 months and 12 months, the recurrence rates of nephrotic syndrome were significantly lower in group C and group D than those of group A and group B (P < 0.05). Conclusion The simple application of ACTH and the combination of Huaiqihuang can relieve the inhibition of long-term using GC on hypothalamic pituitary adrenal axis in FRNS patients.

Key words: nephrotic syndrome, adrenal cortex hormones, glucocorticoids, hydrocortisone, cortisol, Huaiqihuang, hypothalamic pituitary adrenal axis