Shao Kuan-Furong, Guan Feng-Jun, Dong Chen
Department of Pediatrics, Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu 221000, China.
Zhongguo Dang Dai Er Ke Za Zhi. 2021 Jan;23(1):49-54. doi: 10.7499/j.issn.1008-8830.2008135.
To study the clinical effect and mechanism of total glucosides of paeony (TGP) in the adjuvant therapy for children with Henoch-Schönlein purpura nephritis (HSPN).
Sixty-four HSPN children with moderate proteinuria were divided into a TGP treatment group (=34) and a routine treatment group (=30) using a random number table. Thirty healthy children who underwent physical examination were enrolled as the healthy control group. The children in the routine treatment group were given conventional treatment alone, and those in the observation group were given TGP in addition to the conventional treatment. The two groups were compared in the clinical outcome after 4 weeks of treatment. The proportion of follicular helper T (Tfh) cells in peripheral blood and the plasma levels of interleukin-21 (IL-21) and interleukin-4 (IL-4) were measured in the healthy control group and the two HSPN groups. The changes in serum cystatin C (CysC) level and urinary alpha 1-microglobulin (A1M) concentration were compared before and after treatment in the two HSPN groups.
Compared with the healthy children before treatment, the children with HSPN had higher proportion of Tfh cells and expression levels of IL-21 and IL-4 ( < 0.01). The TGP treatment group had a higher overall response rate to treatment than the routine treatment group (94% vs 67%, < 0.05). After treatment, both groups had reductions in the proportion of Tfh cells in peripheral blood, the expression levels of IL-21, IL-4, serum CysC, and urinary A1M concentration. The TGP treatment group had greater reductions in these indices than the routine treatment group ( < 0.01).
TGP has a marked clinical effect in the treatment of HSPN and can reduce the inflammatory response of the kidney and exert a protective effect on the kidney by inhibiting the proliferation of Tfh cells and downregulating the expression of IL-21 and IL-4 in plasma.
研究白芍总苷（TGP）辅助治疗小儿紫癜性肾炎（HSPN）的临床疗效及作用机制。
采用随机数字表法将64例中度蛋白尿的HSPN患儿分为TGP治疗组（n = 34）和常规治疗组（n = 30）。选取30例接受体检的健康儿童作为健康对照组。常规治疗组患儿仅给予常规治疗，观察组患儿在常规治疗基础上加用TGP。治疗4周后比较两组临床疗效。检测健康对照组及两个HSPN组外周血滤泡辅助性T（Tfh）细胞比例、白细胞介素-21（IL-21）和白细胞介素-4（IL-4）血浆水平。比较两个HSPN组治疗前后血清胱抑素C（CysC）水平及尿α1-微球蛋白（A1M）浓度变化。
与治疗前健康儿童相比，HSPN患儿Tfh细胞比例及IL-21、IL-4表达水平更高（P < 0.01）。TGP治疗组治疗总有效率高于常规治疗组（94% 比67%，P < 0.05）。治疗后，两组外周血Tfh细胞比例、IL-21、IL-4表达水平、血清CysC及尿A1M浓度均降低。TGP治疗组这些指标降低幅度大于常规治疗组（P < 0.01）。
TGP治疗HSPN临床疗效显著，可通过抑制Tfh细胞增殖及下调血浆中IL-21和IL-4表达减轻肾脏炎症反应，对肾脏发挥保护作用。
