Effect Of The Treament Of Children’s Primary Nephrotic Syndrome (Simple Type) With The Method Of Chinese Traditional Medicine Shenkangling On Serum IL-6,IL-17 And IL-23

Objective This topic integrateds traditional Chinese treatment in children with primary nephrotic syndrome(Primary Nephrotic Syndrome,PNS).Observing the different expression levels of Th17/Treg cells related cytokines(serum IL-6,IL-17 and IL-23),clinical symptoms and physical and chemical test indexes and efficacy evaluation.To explore the pathogenesis of PNS and the mechanism of Shenkangling reducing proteinuria,and the mechanism of supplementing Yishen Huoxue method on PNS(simple type)in order to improve clinical efficacy.Methods Select 30 cases who were diagnostic PNS(simple type)and treated in the People’s hospital and the second People’s hospital affiliated to Fujian University of Traditional Chinese Medicine(FJTCM)as treatment group.And 30 cases were selected as the healthy group.Both groups includs from December 1,2020 to December 31,2021 and all children aged 2-14 years old.Evaluate the treatment grou before and after the cytokines(serum IL-6,IL-17 and IL-23)level change and clinical characteristics(serum albumin,cholesterol,riglyceride,low density lipoprotein and 24-hour urine protein).SPSS 26.0 statistical software was used to analyze the collected data.Pearson correlation and Logistic regression analysis were performed to analyze the related risk factors of treaments with PNS.Results According to the inclusion and exclusion criteria,a total of 30 children were included in this project,including 23 boys and 7 girls,most of whom were 7-12 years old.There were 3 cases of shedding during treatment due to inability to cooperate with clinical observation and follow up and medication regimen.Before treatment: there were no significant differences in gender and age composition between the treatment group and the healthy group(P all > 0.05),and the levels of serum IL-6,IL-17 and IL-23 in the treatment group were significantly higher than those in the control group(P all < 0.05).After 4 weeks of treatment,serum IL-6,IL-17 and IL-23 in the treatment group were significantly higher than those in the healthy group(P all < 0.01).Compared with before treatment,there were no significant differences in serum IL-6 and IL-17 in treatment group(P > 0.05),and the level of IL-23 in treatment group was significantly lower than before treatment(P < 0.01).The levels of urinary protein and triglyceride were significantly lower than those before treatment(P < 0.01),and there were no significant differences in serum albumin,total cholesterol and low density lipoprotein levels(P > 0.05).After 12 weeks of treatment,the serum IL-6 level in the treatment group was lower than that in the healthy group(P < 0.05),while there were no significant differences in IL-17,IL-23 and the healthy group(P > 0.05).Compared with before treatment,serum IL-6,IL-17 and IL-23 in the treatment group were significantly lower than before treatment(P < 0.01).There were no significant differences in serum IL-6 and IL-17 compared with 4 weeks after treatment(P > 0.05).There were statistically significant differences in urinary protein quantification,triglyceride,total cholesterol,low density lipoprotein and serum albumin in the treatment group compared with before treatment(P all < 0.05),among which the changes of urinary protein quantification,triglyceride and serum albumin levels were more obvious(P all < 0.01).After 12 weeks of treatment,17 of the 27 children received complete remission and 10 partial remission,and no adverse drug reactions were found during the observation of clinical efficacy.Conclusions1.Serum IL-6,IL-17 and IL-23 levels in children with PNS were significantly increased,deepening the Th17/Treg cell imbalance theory on the pathogenesis of PNS.IL-6,IL-17 and IL-23 as cytokines can directly or indirectly expand the influence of Th17 cells on glomerular foot cells and thylakoid cells,thus participating in the occurrence and development of paediatric PNS.2.Children with PNS(simple type)can reduce IL-6,IL-17 and IL-23 expression after 4weeks of combined Chinese and Western medicine treatment,and further reduce IL-6 and IL-23 expression after 12 weeks of treatment,suggesting that the focus of combined Chinese and Western medicine approach treatment is to continuously inhibit IL-6 and IL-23,and then regulate the expression of Th17 cells and IL-17 to reduce local inflammation in the kidney.The effect of the combined Chinese and Western medicine approach is to continuously inhibit IL-6 and IL-23,and then regulate the expression of Th17 cells and IL-17 to reduce local inflammation in the kidney.3.For children with PNS(simple type)combined with secondary conflicts such as disorders of lipid metabolism and blood hypercoagulation,the combination of Chinese and Western medicine treatment plays a significant role in raising serum albumin and lowering abnormally elevated urine protein,total serum cholesterol,triglycerides and low-density lipoprotein,thus alleviating the condition of the child and improving clinical efficacy.No adverse reactions were reported in this study,confirming its reliable safety and application value.