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。
Objective To observe the effects and safety of adrenocorticotropic hormone（ACTH） combined withHuaiqihuang on frequent relapse nephrotic syndrome（FRNS） in children. Methods Fifty-five child patients with FRNSwere divided into control group, which was given glucocorticoid（GC） to maintain the treatment（group A, n=10）, Huaiqihuanggroup（group B, n=17）, ACTH group（group C, n=14） and ACTH combined with Huaiqihuang group（combined treatmentgroup, group D, n=14）. Continuous treatment was for 12 months. The GC treatment doses, the levels of basal secretion ofadrenal cortex and adrenal cortex reserve were recorded at 6-month and 12-month respectively. And the recurrence rate andadverse reactions were observed in four groups. Results After 6-month treatment, the doses of GC were significantly lowerin group C and group D than those in group A and group B（P 〈 0.05）. The levels of basal secretion of adrenal cortex wereincreased in turn in group A^D（P 〈 0.05）. After 12-month treatment, the doses of GC were significantly decreased in groupC and group D than those in group A and group B, while the level of basal secretion of adrenal cortex and adrenal cortexreserve 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 lowerin group C and group D than those of group A and group B（P 〈 0.05）. Conclusion The simple application of ACTH andthe combination of Huaiqihuang can relieve the inhibition of long-term using GC on hypothalamic pituitary adrenal axis inFRNS patients.
出处
《天津医药》
CAS
2017年第1期54-57,共4页
Tianjin Medical Journal
基金
天津市中医药管理局中医
中西医结合科研专项课题(13127)
