Clinical Analysis Of ACEI/ARB And Huaiqihuang Granule In The Treatment Of Mild Proteinuria In Children With Henoch Schonlein Purpura Nephritis

Objective:Objective To observe the curative effect of angiotensin converting enzyme inhibitors(ACEI)/ angiotensin receptor blocker(ARB)in the treatment of mild proteinuria in children with Henoch Schonlein purpura nephritis(HSPN),and whether there is any difference between ACEI and ARB,And Huaiqihuang granules(hqh)adjuvant treatment.Methods: From November 2016 to April 2019,114 children with mild proteinuria in a multicenter study of children with Henoch Schonlein purpura nephritis participated by 10 hospitals were selected as the observation objects,with the average age of(9.50 1 ±There were 63 males and 51 females.There was no significant difference in age and gender among the groups;They were divided into 4 groups,32 cases in group A(treated with ACEI alone),26 cases in group B(treated with ARB alone),31 cases in group C(ACEI + hqh)and 25 cases in group D(ARB + hqh).After treatment,the clinical manifestations,urine routine,24-hour urine protein(24hup),blood routine,liver and kidney function,fasting blood glucose,blood lipid and blood pressure were observed,To explore the therapeutic effect.Results:(1)The 114 children with hematuria and urinary protein changes were treated with ACEI/ARB and Huaiqihuang granules,and followed up for 6 months.In group A,2 children fell off,while in group B,4 children fell off.After treatment,11 children’s proteinuria did not turn negative(5 cases in group A,4 cases in group B,1 case in group C,1 case in group D).Only 1 child(group A)had increased urinary protein,24 h up <25.0mg/kg/d,In group A,the cure rate of proteinuria was 83.3%,and the effective rate was 96.7%;In group B,the cure rate of proteinuria was 81.8%,and the effective rate was100%;In group C,the cure rate of proteinuria was 96.8%,and the effective rate was100%;In group D,the cure rate of proteinuria was 96.0%,and the effective rate was100%;15 cases of children with hematuria did not turn negative(6 cases in group A,5cases in group B,2 cases in group C and 2 cases in group D).Among them,6 cases of children’s urine red blood cells were higher than before treatment(2 cases in group A,2cases in group B,1 case in group C and 1 case in group D).The cure rates of hematuria were 80.0%,77.3%,93.5% and 92%,respectively;The effective rates were 93.3%,91.0%,96.7% and 96.0% respectively(2)There was no significant difference between group A and group B after treatment(P > 0.05)(3)After treatment,hematuria and proteinuria in group C decreased more significantly,and the cure rate of hematuria and proteinuria in group C was higher than that in group A(P < 0.05)(4)After treatment,hematuria and proteinuria in group D decreased more significantly,and the cure rate of hematuria and proteinuria in group D was higher than that in group B(P < 0.05)(5)There was no significant change in liver and kidney function after treatment in all children.In group A,2 children had dry cough,no dizziness and hypotension.Conclusion: ACEI/ARB alone was effective in the treatment of mild proteinuria in children with Henoch Schonlein purpura nephritis;ACEI/ARB combined with hqh is more effective in the treatment of HSPN with mild proteinuria;There was no dizziness and hypotension in the course of ACEI/ARB,which provided the basis for the treatment of children with mild proteinuria of Henoch Schonlein purpura nephritis.