目的 探討復(fù)方腎炎片聯(lián)合環(huán)磷酰胺治療兒童過敏紫癜性腎炎的臨床療效。方法 選取2020年2月—2021年2月河南中醫(yī)藥大學(xué)第一附屬醫(yī)院收治的98例過敏紫癜性腎炎患兒，按照隨機(jī)數(shù)字表法將所有患者分為對照組和治療組，每組各49例。對照組口服環(huán)磷酰胺片，2~6 mg/kg，1次/d。治療組在對照組治療基礎(chǔ)上口服復(fù)方腎炎片，3片/次，3次/d。兩組連續(xù)治療7 d。觀察兩組的臨床療效，比較兩組癥狀緩解時間、腎功能指標(biāo)和血清因子。結(jié)果 治療后，治療組總有效率是97.96%，顯著高于對照組的79.59%（P<0.05）。治療后，治療組皮膚紫癜、關(guān)節(jié)疼痛、腹痛、血尿緩解時間均顯著短于對照組（P<0.05）。治療后，兩組尿紅細(xì)胞、24 h尿蛋白定量（24 h Upro）、尿微量白蛋白（mALB）均顯著降低（P<0.05）；治療后，治療組腎功能指標(biāo)改善優(yōu)于對照組（P<0.05）。治療后，兩組患者白細(xì)胞介素-4（IL-4）、轉(zhuǎn)化生長因子-β1（TGF-β1）、基質(zhì)金屬蛋白酶2（MMP-2）、腫瘤壞死因子α（TNF-α）水平均較治療前顯著降低（P<0.05）；治療后，治療組血清因子水平顯著低于對照組（P<0.05）。結(jié)論 復(fù)方腎炎片聯(lián)合環(huán)磷酰胺治療兒童過敏紫癜性腎炎具有較好的臨床療效，可有效改善患兒癥狀，改善炎癥反應(yīng)，降低蛋白尿與血尿水平，具有一定的臨床推廣應(yīng)用價值。

Objective To investigate the therapeutic effect of Compound Shenyan Tablets combined with cyclophosphamide in treatment of allergic purpura nephritis in children. Methods A total of 98 children with allergic purpura nephritis admitted to the First Affiliated Hospital of Henan University of Traditional Chinese Medicine from February 2020 to February 2021 were selected. According to the random number table method, all patients were divided into control group and treatment group, with 49 cases in each group. Patients in the control group were po administered with Cyclophosphamide Tablets, 2-6 mg/kg, once daily. Patients in the treatment group were po administered with Compound Shenyan Tablets on the basis of the control group, 3 tablet/time, three times daily. Patients in two groups were treated for 7 d. After treatment, the clinical efficacy was evaluated, and symptom relief time, renal function indexes and serum factors were compared between the two groups. Results After treatment, the total effective rate of the treatment group was 97.96%, significantly higher than 79.59% of the control group (P < 0.05). After treatment, the relief time of skin purpura, joint pain, abdominal pain, and hematuria in treatment group was significantly shorter than that in control group (P < 0.05). After treatment, urine erythrocyte, 24 h urine protein quantitation (24 h Upro) and urine microalbumin (mALB) in two groups were significantly decreased (P < 0.05); After treatment, the renal function index of the treatment group improved better than that of the control group (P < 0.05). After treatment, the levels of interleukin-4 (IL-4), transforming growth factor -β1 (TGF-β1), matrix metalloproteinase 2 (MMP-2) and tumor necrosis factor α (TNF-α) in two groups were significantly decreased compared with before treatment (P < 0.05). After treatment, the level of serum factor in treatment group was significantly lower than that in control group (P < 0.05). Conclusion Compound Shenyan Tablets combined with cyclophosphamide has good clinical efficacy in treatment of allergic purpura nephritis in children, and can effectively improve the symptoms of children, improve inflammatory response, reduce proteinuria and hematuria levels, which has a certain clinical application value.

R985

河南省醫(yī)學(xué)科技攻關(guān)計劃項目（LHGJ20200656）