The Clinical Significance And Influence On GCR Resulted From TWHF For Children Nephrotic Syndrome

objective: To study the mechanism of Tripterygium Wilfordii Hook F. (TWHF) used with prednisone for children's nephrotic syndrome (NS) and study the possibility of TWHF replacing part of glucocorticoid (GC) for NS.Methods : All the cases of NS were divided into three groups: group A (11 cases, prednisone 2mg/kg d, added TWHF 1.5mg/kg d, after two weeks ), group B (10 cases, prednisone 1 mg/kg d, added TWHF 1.5mg/kg d, after two weeks), positive contrast group (11 cases, only prednisone 2mg/kg d was used), Took the patients' venous blood at 8:30 am, used heparin as the anticoagulant. 3H-Dex as the ligand, measured GCR in peripheral lymphocytes with the radio ligand binding assay method. The three group's GCRs and the lasting time during which the albuminuria become negative, and the relapse times,were compared.Results: The GCR level in peripheral lymphocytes of normal children is 6573 2813dpm, and GCR in group A, B and positive contrast group is respectively 4942 1839dpm, 4983 1846dpm, 4854 1755dpm. GCR in all patients is obviously less than in normal children and there is significantly different between them, but there is no significant difference between the contrast group and the group A and B(p>0.05). GCR reduces apparently after one week from which GC is used to cure the nephrotic syndrome patients. GCR is respectively 2348 1012dpm, 2366 1026, 2297 869dpm in, group A, B and contrast group. GCR increases after three weeks from which GC is used to treat the NS patients, but there is no significant difference in positive contrast group (p>0.05) and significant difference in group A and B (p<0.05). The lasting time of aluminuria in group A and B is shorter than in positive contrast group. The relapse times in group A and B are much less than in positive contrast group(p<0.05), but there is no significant difference between group A and B(p>0.05).Conclusion: TWHF for NS is obviously effective, when usedwith prednisone, the dosage of prednisone can be reduced and the lasting time of albuminuria can be shortened also and the relapse times can e lessened. The mechanism may be that TWHF resists the down-regulation use GC to GCR, so to add the effect resulted from GC combined with GCR.