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