Efficacy And Safety Of Different Dosage Multi-Glycosides Of Tripterygium Wilfordii Hook. F. With Chinese Medicine For Hematuria In Children With Henoch-Sch(?)nlein Purpura Nephritis

Objective To evaluate the efficacy and safety of different dosage multi-glycosides of triptergium wilfordii hook f (MGTW) for hematuria in children with Henoch-sch?nlein Purpura Nephritis (HSPN), and explore the optimum dosage of MGTW for hematuria in children with Henoch-sch?nlein Purpura Nephritis.Methods 90 children were enrolled in this 12-week randomized study, and they are all the hospitalized patients with hematuria of HSPN in our pediatric hospital:35 cases with isolated hematuria and 55 cases with the hematuria and proteinuria. All the patients were randomly divided into 3 groups(A,B and C), every group has 30 cases, and separately received the treatment with 1 mg·kg^-1·d^-1of MGTW(group A), 1.5 mg·kg^-1·d^-1of MGTW(group B), and 2 mg·kg^-1·d^-1of MGTW(group C).The whole period of treatment last 12 weeks. After 4 weeks, all the three groups continued the treatment 8 weeks with MGTW according to the dosage of 1 mg·kg^-1·d^-1.we assessed the treatment once a week in the first month, and every two weeks in the later two months. We constantly observe the change of the hematuria and proteiunria and the side-effect.Results①In group A:14 patients (46.7%) were cured clinically, 5 patients (16.7%) were prominently improved and 5 patients (16.7%) were improved. There were 6 patients (20.0%) with inefficacy. The mean time of urinary red blood cell (URBC) being negative is 46.0 days. In group B:21 patients (70.0%) were cured clinically, 4 patients (13.3%) were prominently improved and 3 patients (10.0%) were improved. There were 2 patients (6.7%) with inefficacy. The mean time of URBC being negative is 39.9 days. In group C:22 patients (73.3%) were cured clinically, 4 patients (13.3%) were prominently improved and 2 patients (6.7%) were improved. There were 2 patients (6.7%) with inefficacy. The mean time of URBC being negative is 39.2 days. The efficacy of group B is significantly better than group A's (P<0.05), and there is no statistically significant difference between group B and group C (P>0.05). The clinical manifestation of patients with isolated hematuria is better than the patients with hematuria and minor proteiunria (P<0.05). All the patients with URBC still positive showed their renal tubulerinterstitial lesions.②All the patients in this study can tolerate the whole treatment. The transient liver enzyme ascending and Leukopenia are the common side-effects. No patient shows the serious Leukopenia, skin pigmentation and menstrual disorders. The side-effect of group B is significantly less than group C (P<0.05), and there is no statistically significant difference between group B and group A (P>0.05).③the determined 47 cases urinary Edothelin^-1 (ET^-1) levels before and after treatment are significantly different, what'more, show significantly correlation with the degree of the renal lesion.Conclusions With Chinese medicine, 1.5 mg·kg^-1·d^-1 of MGTWF in the first month and then change into 1 mg·kg^-1·d^-1 of MGTWF in the later two month, is a best therapy with MGTWF for hematuria in children with HSPN, having better efficacy and less side-effect.