Clinical Effect of Total Glucosides of Paeonia as the adjuvant therapy on Hematuria and Proteinuria Purpura Nephritis and Its Effect on Serum Cytokines

Abstract

Objective To investigate the efficacy of total glucosides of paeony (TGP) in the treatment of hematuria and proteinuria purpura nephritis (HSPN) and serum interleukin-6 (IL-6), interleukin-1 beta (IL-1 beta) and interleukin-18 (IL-18). Methods From June 2017 to December 2018, 64 cases of children with primary hematuria and proteinuria purpura nephritis admitted to the department of pediatrics affiliated hospital of Xuzhou medical university were selected as study subjects, and were divided into control group (33 cases) and observation group (31 cases) according to random number method.The children in the control group were given oral administration of poniasone acetate, and the observation group was treated with TGP on the basis of the control group.Both groups received continuous treatment for 4 weeks.Two groups′ before and after treatment expression level of serum interleukin-6, interleukin-1β and interleukin-18, and level of clinic indicator such as Urinary red biood cell (URBC), 24 hour urinary protein quantity, urinary immune globulin G (IGU), micro-albuminuria (urinary microalbumin, MAU), α-Microglobulin (α1-MG) and urinary transferrin (TFRU) is made a comparison. Results After 4weeks of treatment, the total clinical effective rate of the observation group (93.5% (29/31)) was significantly higher than that of the control group (72.7% (24/33)), and the difference between the two groups was statistically significant (χ2=4.868, P 0.05). After treatment, in the observation group, Serum IL-6 ( (16.68±6.83) ng/L and (32.24±6.99) ng/L, t=12.373), IL-1β((63.83 ±8.97)ng/L and (85.59±9.42) ng/L, t=9.758), IL-18((64.52±5.46) ng/L and (88.50±5.54) ng/Ll, t=18.899), 24 h urinary protein quantification (0.3 (0.21, 0.36) g/24 h and 1.0 (0.65, 1.23) g/24 h, Z=-4.861), URBC (15.30 (3.80, 36.80)×106/L and 168.9 (58.4, 324.0)×106/L, Z=-4.840), were lower than before treatment (all P<0.05); After treatment, in the control group, Serum IL-6 ((23.62±5.95) pg/ml and (33.44±4.68) pg/ml, t=9.149), IL-1β ((68.67±6.31) pg/ml and (86.59±8.71) pg/ml, t=10.617), IL-18((71.25±9.69) pg/ml and (89.87±6.68) pg/ml, t=11.506), 24 h urinary protein quantification (0.42 (0.33, 0.56) g/24 h and 0.94 (0.74, 1.25) g/24 h, Z=-5.013), URBC (57.00 (39.25, 77.50)×106/L and 145.60 (58.20, 360.85)×106/L, Z=-4.762), were lower than before treatment (all P<0.05). The difference between the two groups was statistically significant (P<0.05). Conclusion The adjuvant effect of total glucoside of white peony root on hematuria and proteinuria purpura nephritis is significant, which can reduce the level of hematuria and proteinuria and improve the renal symptoms of children.Its mechanism of action may be to reduce renal inflammation and protect the kidney by down-regulating the expression of serum IL-6, IL-1 and IL-18. Key words: Total glucosides of paeonia; Henoch-Schonlein purpura nephritis; Interleukin1β; Interleukin18; Interleukin6