目的:观察益气养阴方对儿童原发性肾病综合征(primary nephrotic syndrome，PNS)调节性T细胞和免疫球蛋白水平的影响。方法:59例PNS患儿按照就诊顺序分为研究组(n=31)和对照组(n=28)。对照组给予醋酸泼尼松片，研究组在对照组治疗基础上给予益气养阴方，两组均连续治疗6个月。比较两组患儿治疗前、治疗3个月和治疗6个月的24小时尿蛋白定量(24-hour urinary protein quantity，24hUTP)、血清白蛋白(albumin，ALB)、总胆固醇(total cholesterol，TC)、尿素氮(urea nitrogen，BUN)、血清肌酐(serum creatinine，SCr)、淋巴细胞、NK细胞、调节性T细胞(CD4+CD25+CD127-/lowTreg)以及免疫球蛋白水平，并比较两组患儿尿蛋白转阴时间，感染次数及复发情况。结果:研究组有效率为96。77％，高于对照组的78。57％(P＜0。05)。两组治疗3个月和治疗6个月时患儿24hUTP、BUN、SCr和TC水平均明显低于治疗前，ALB明显高于治疗前(P＜0。05);研究组治疗3个月时患儿24hUTP、BUN、SCr和TC水平低于同期对照组，ALB高于同期对照组(P＜0。05)。研究组治疗3个月和治疗6个月时患儿T淋巴细胞亚群(CD3+、CD4+)、B淋巴细胞(CD3-CD19+)、NK细胞(CD3-CD16+CD56+)、调节性T细胞(CD4+CD25+CD127-/lowTreg)和血清IgG、JgA水平均高于治疗前，B淋巴细胞(CD3-CD19+)和血清IgE水平低于治疗前(P＜0。05);与治疗前比较，对照组治疗3个月时，上述各项指标均明显改善，但治疗6个月时，T淋巴细胞亚群、调节性T细胞、血清IgA、IgG水平出现下降，B淋巴细胞和IgE水平高于治疗3个月时水平。研究组治疗3个月和治疗6个月T淋巴细胞亚群、B淋巴细胞、NK细胞、调节性T细胞和血清IgG、IgA、IgE指标的改善程度均优于对照组(P＜0。05)。研究组患儿尿蛋白阴转时间、感染次数、复发率明显低于对照组(P＜0。05)。结论:益气养阴方治疗PNS疗效确切，可缩短尿蛋白转阴时间，调节细胞免疫和体液免疫，改善机体免疫失衡状态，增强抗感染能力，降低复发率。
Effects of Yiqi Yangyin Formula on Immune Function of Children with Primary Nephrotic Syndrome
Objective:To observe the effects of Yiqi Yangyin Formula on regulatory T cells and immunoglobulin levels in children with primary nephrotic syndrome(PNS).Methods:Fifty-nine children with PNS were divided into a study group(n=31)and a control group(n=28)according to the order of consultation.The control group was given prednisone acetate tablets,and the study group was given Yiqi Yangyin Formula based on the treatment of the control group.Both groups were treated continuously for 6 months.The 24-hour urinary protein quantity(24hUTP),serum albumin(ALB),total cholesterol(TC),urea-nitrogen(BUN),serum albumin(ALB),total cholesterol(TC),urea-nitrogen(BUN),and urea-nitrogen(BUN)were compared between the two groups before the treatment,at the end of the 3-month period,and at the end of the 6-month period.nitrogen(BUN),serum creatinine(SCr),lympho-cytes,NK cells,regulatory T cells(CD4+CD25+CD 127-/lowTreg),and immunoglobulin levels,and to compare the time of urinary protein conversion,the number of infections,and recurrence in the two groups.Results:The effective rate of the study group was 96.77％,which was higher than that of the control group(78.57％)(P＜0.05).The 24 h Pro,BUN,SCr and TC levels of the chil-dren in both groups at 3 months and 6 months of treatment were significantly lower than those before treatment,and ALB was significant-ly higher than that before treatment(P＜0.05);the 24 h Pro,BUN,SCr and TC levels of the children in the study group at 3 months of treatment were lower than those of the control group at the same time,and ALB was higher than that of the control group at the same time(P＜0.05).Children's T lymphocyte subsets(CD3+,CD4+),B lymphocytes(CD3-CD 19+),NK cells(CD3-CD16+CD56+),regulatory T cells(CD4+CD25+CD 127-/lowTreg),and serum IgG and IgA levels were higher than those before the treatment in the study group at 3 months and 6 months of treatment,and the levels of B lymphocytes(CD3-CD19+)and serum IgE levels were lower than before treatment(P＜0.05);compared with before treatment,all of the above indexes were significantly improved in the control group at 3 months of treatment,but a decrease in T lymphocyte subpopulations,regulatory T cells,serum IgA and IgG levels,and an in-crease in the levels of B lymphocytes and IgE compared with those at 3 months of treatment were observed at 6 months of treatment.The degree of improvement in T lymphocyte subsets,B lymphocytes,NK cells,regulatory T cells and serum IgG,IgA and IgE indexes in the study group was better than that in the control group at 3 months and 6 months of treatment(P＜0.05).The time to negative urine pro-tein,the number of infections and the recurrence rate of children in the study group were significantly lower than those in the control group(P＜0.05).Conclusion:The efficacy of Yiqi Yangyin Formula in treating PNS is precise,which can shorten the time of urine protein negative conversion,regulate cellular immunity and humoral immunity,improve the state of immune imbalance of the body,en-hance the ability of anti-infection and reduce the recurrence rate.
primary nephrotic syndrome in childrenYiqi Yangyin Formulaimmune functionglucocorticoidregulatory T cellsimmu-noglobulin
万方数据
维普
