Yoshikawa N, Ito H, Takekoshi Y, Honda M, Awazu M, Iijima K, Nakamura H, Seino Y, Takeda N, Hattori S, Matsuda I
Faculty of Health Science, Kobe University School of Medicine.
Nihon Jinzo Gakkai Shi. 1998 Nov;40(8):587-90.
The most appropriate initial treatment for children with steroid-responsive nephrotic syndrome is controversial. Initial treatment with 18-week prednisolone and the Chinese herbal medicine. Sairei-to, may prevent subsequent relapse. To determine whether similar results can be obtained with a combination of just initial 8-week prednisolone and Sairei-to, we compared the effects of such treatment with those of treatment with 18-week prednisolone and Sairei-to in 196 children with steroid-responsive nephrotic syndrome. The patients were randomly assigned to receive 8-week (group 1) or 18-week (group 2) prednisolone for the initial therapy. All patients received Sairei-to for 2 years in addition to prednisolone. Eighty-eight of the 98 patients in group 1 and 83 of the 98 patients in group 2 completed their trial. At entry, the two groups of patients did not differ in their clinical and laboratory findings. During the 2-year trial, 62 group 1 patients (70%) and 54 group 2 patients (65%) had relapses, and 19 group 1 patients (21%) and 20 group 2 patients (24%) had frequent relapses. The present study demonstrates that a combination of initial 8-week prednisolone and 2-year Sairei-to is effective in children with steroid-responsive nephrotic syndrome.
对于类固醇反应性肾病综合征患儿，最恰当的初始治疗方法存在争议。初始使用18周泼尼松龙及中药柴苓汤治疗，可能预防后续复发。为确定仅初始8周泼尼松龙与柴苓汤联合使用是否能获得相似结果，我们将196例类固醇反应性肾病综合征患儿中这种治疗方法的效果与18周泼尼松龙和柴苓汤治疗的效果进行了比较。患者被随机分配接受初始治疗8周（第1组）或18周（第2组）的泼尼松龙。所有患者除泼尼松龙外还接受2年柴苓汤治疗。第1组98例患者中有88例、第2组98例患者中有83例完成了试验。入组时，两组患者的临床和实验室检查结果无差异。在2年试验期间，第1组62例患者（70%）复发，第2组54例患者（65%）复发，第1组19例患者（21%）频繁复发，第2组20例患者（24%）频繁复发。本研究表明，初始8周泼尼松龙与2年柴苓汤联合使用对类固醇反应性肾病综合征患儿有效。
