【作者】 张莉；

【导师】 郑健；

【作者基本信息】 福建中医学院 ， 中医儿科学， 2007， 硕士

【摘要】 目的：通过观察中药肾康灵干预治疗小儿频复发性肾病（FRNS）对尿RBP、α₁-MG和NAG酶的影响，探讨小儿FRNS的发病机制和中医肾康灵干预治疗的作用机制。方法：选择15例健康儿童作为正常组，选择符合FRNS诊断标准的患儿30例，随机分为两组，A组（西药对照组）15例、B组（肾康灵+西药治疗组）15例。观察A，B两组在治疗前后尿RBP、α₁-MG和NAG酶的变化和疗效比较。结果：治疗前A、B两组尿RBP、α₁-MG和NAG酶比较无显著差异（P均＞0.05），而与正常组比较明显升高，差异非常显著（P均＜0.01）；治疗后A、B两组尿RBP、α₁-MG和NAG酶水平与治疗前比较均有所降低，差异显著（P值分别为＜0.05和＜0.01），而B组比A组降低更为明显，A、B两组比较差异显著（P＜0.05）。治疗前A、B两组24h尿蛋白定量和血浆白蛋白比较无显著差异（P均＞0.05）；治疗后A、B两组24h尿蛋白定量降低、血浆白蛋白升高，与治疗前相比有显著差异（P均＜0.01），A、B两组比较差异显著（P均＜0.05）。结论：1．FRNS患儿治疗前尿RBP、α₁-MG和NAG酶均明显高于正常组，说明FRNS患儿存在肾小管间质损害的临床表现。2．中药肾康灵干预治疗能明显降低FRNS患儿异常升高的尿RBP、α₁-MG和NAG酶，从而改善患儿肾小管间质功能，提高临床疗效。3．尿RBP、α₁-MG和NAG酶可以作为小儿FRNS肾小管间质损害和中医肾虚血瘀证以及益肾活血法应用的客观评价指标。更多还原

【Abstract】 Objective: To investigate The Effect of Decoction Shenkangling on UrinaryRetinal-Binding Protein、α₁-Microglobulin、N-acetyl-β-D-glucosaminidase ofChildren with Frequently Relapsing Nephrotic SyndromeMethods: 15 healthy children were selected as normal control group. 30 childrenwith Frequently Relapsing Nephrotic Syndrome were divided into 2 groups atrandom: Group A （prednisone）and group B （shenkangling+prednisone）. Before andafter the treatment, Urinary Retinal-Binding Protein、α₁-Microglobulin、N-acetyl-β-D-glucosaminidase of all patients were measured. Statisticalanalysis was performed by SPSS 12.0.Results: Compared with normal control group, the levels of UrinaryRetinal-Binding Protein、α₁-Microglobulin、N-acetyl-β-D-glucosaminidase ofGroup A and group B were significantly increased（P＜0.01） before treatment. Aftertreatment, a greatly decreasing had appeared in Group A and group B（P＜0.01）, andthere appeared a better effect in group B than in group A after treatment （P＜0.05）.The level of 24h urinary protein quantity was greatly decreased and the levelof serum albumin was significantly increased in group A and group B（P＜0.01）. GroupB was much better than group A in decreasing the level of 24h urinary proteinquantity, increasing the level of serum albumin （P＜0.05）.Conclusion: 1. The Urinary Retinal-Binding Protein、α₁-Microglobulin、N-acetyl-β-D-glucosaminidase of children with Frequently Relapsing NephroticSyndrome were all increased and maybe there appear tubulointerstitial lesionsin these children. and the above abnormalities could be amelioratedby treatment of Decoction Shenkangling and the curative effect of tubulointerstitial lesionsof children with Frequently Relapsing Nephrotic Syndrome by shenkanglingcombined with prednisone is better than prednisone. 3. The UrinaryRetinal-Binding Protein、α₁-Microglobulin、N-acetyl-β-D-glucosaminidas maybe regarded as a sensitive index in aspect of healing tubulointerstitial lesionsof children with Frequently Relapsing Nephrotic Syndrome by treatment ofcombination of Chinese medicine and Western medicine and "Kidney Deficiency andBlood Stasis" and therapy of "benefiting the kidney and promoting bloodcirculation" in TCM.更多还原