世界中医药

目的：探讨王伯岳麻连汤加味习用方辨治小儿急性肾小球肾炎临床疗效，分析可能的疗效机制，为小儿急性肾小球肾炎患儿治疗方案选择提供参考。方法：选取2015年4月至2017年4月深圳市宝安中医院收治的急性肾小球肾炎患儿60例作为研究对象，按照就诊顺序编号，单号为对照组和双号为观察组，每组30例。对照组采用常规西医治疗，予以抗感染、利尿、降压常规对症治疗，观察组在对症治疗药物减半的基础上，再予以王伯岳麻连汤加味习用方辨治。2组患者均连续治疗2周为1个疗程。比较2组患者治疗前、治疗结束后肾功能指标（24 h尿蛋白定量、血肌酐（Scr）、尿蛋白（BUN））、血清炎性指标如抗链球菌溶血素O、白细胞介素-6（IL-6）、白细胞介素-10（IL-10）、红细胞沉降率、免疫功能指标如CD3+、CD4+、CD8+、CD4+/CD8+变化情况。治疗结束后评定临床疗效并比较，收集治疗过程中患者药物不良反应情况并比较。结果：治疗后观察组患者临床疾病治疗有效率明显高于对照组，差异有统计学意义(P<005)。治疗后，2组患者24 h尿蛋白定量、Scr、BUN较治疗前均明显降低，且观察组明显低于对照组，差异有统计学意义（P<005）。治疗后，2组抗链球菌溶血素O、IL-10均较治疗前明显降低，且观察组低于对照组，差异有统计学意义（P<005）；2组IL-6、红细胞沉降率均较治疗前明显升高，且观察组高于对照组，差异有统计学意义（P<005）。治疗后，2组患者CD3+、CD4+、CD8+、CD4+/CD8+比均较治疗前明显升高，且观察组高于对照组，差异有统计学意义（P<005）；对照组药物不良反应率明显高于观察组，差异有统计学意义（P<005）。结论：王伯岳麻连汤加味习用方辨治小儿急性肾小球肾炎，具有宣肺利水、清热解毒的功效，从而增强患者抗菌能力、肾脏功能及免疫功能，达到提升患者临床疗效的效果，且抗菌药物剂量减少，安全性高。

English Summary:

To explore the clinical effects of Wang Boyue modified Malian Decoction in treating children with acute glomerulonephritis based on syndrome differentiation，and to analyze the possible mechanism of curative effect，so as to provide a reference for the choice of treatment programs for children with acute glomerulonephritis.Methods:A total of 60 children with acute glomerulonephritis admitted to Shenzhen Baoan Hospital of Traditional Chinese Medicine from April 2015 to April 2017 were selected as the study subjects.The patients were numbered according to the order of treatment.The odd number was the control group(30 cases)and the even number was the observation group(30 cases).The control group was treated with routine western medicine，anti-infection，diuresis，antihypertensive routine symptomatic treatment，and the observation group was treated with Wang Boyue modified Malian Decoction favored prescription on the basis of symptomatic treatment drugs halved.Two groups of children were treated for 2 weeks for a course of treatment.The changes of renal function index(24 h urinary protein，serum creatinine(Scr)，urinary protein(BUN)，serum inflammatory index(anti-streptococcal hemolysin O，interleukin-6(IL-6)，interleukin-10(IL-10)，erythrocyte sedimentation rate(ESR)，immune function index(CD3+，CD4+，CD8+，CD4+/CD8+)were compared between the 2 groups before and after treatment.After treatment，the clinical efficacy was evaluated and compared，and adverse drug reactions were collected and compared.Results:1)The total effective rate of clinical diseases in the study group was significantly higher than that in the control group(P<005).2)After treatment，24-hour urinary protein，Scr，BUN in both groups were significantly decreased than those before treatment，and the observation group was significantly lower than the control group(P<005).3)After treatment，the levels of anti-streptolysin O and IL-10 in the 2 groups were significantly decreased than those before treatment，and the levels of IL-6 and ESR in the observation group were significantly increased than those in the control group(P<005).4)After treatment，the CD3+，CD4+，CD8+，CD4+/CD8+ ratio of the 2 groups were significantly increased than before treatment，and the observation group was higher than the control group(P<005).5)The adverse drug reaction rate of the control group was significantly higher than that of the observation group(P<005).Conclusion:The modified prescription of Wang Boyue Malian Decoction has the effects of dispersing lung，diuresis，clearing away heat and detoxification，thus enhancing the antibacterial ability，renal function and immune function of children，and improving the clinical efficacy of children with acute glomerulonephritis.The dosage of antibiotics is reduced，the safety is high，and the clinical value is high.

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