Effect of Huaiqihuang Granules Combined with Comprehensive Nursing on Children with Primary Nephrotic Syndrome

Abstract

Background. To observe the effect of Huaiqihuang granules combined with comprehensive nursing intervention on children with primary nephrotic syndrome (PNS) and its effect on renal function index. Methods. A total of 104 patients were included, and the patients were randomly divided into two groups, with 52 cases in each group. The control group was treated with glucocorticoid, and the study group was treated with Huaiqihuang granules. The clinical efficacy of the two groups was observed. The levels of TG, TC, EGFR, 24 h UTP, BUN, Scr, IgA, IgG, IgM, IFN-γ and TNF-α were compared between two groups before and after treatment. The incidence of adverse reactions and recurrence rate after treatment were compared between the two groups. Results. The effective rate of the study group (94.23%) was significantly higher than that of the control group (78.85%). Before treatment, there was no significant difference in TG and TC levels between the two groups. After treatment, the levels of TG and TC in both groups were decreased, and the decrease was more obvious in the study group. Compared with before treatment, the levels of 24 h UTP, BUN, Scr, IFN-γ, and TNF-α in both groups were significantly decreased after treatment, while EGFR, IgA, IgG, and IgM levels were significantly increased. Compared with the control group, the changes of each index in the study group were more obvious after treatment. After treatment, the incidence of adverse reactions and recurrence rate in the study group were significantly lower than those in the control group. Conclusions. Huaiqihuang granules combined with comprehensive nursing treatment in children with PNS can reduce the occurrence of recent recurrence and adverse reactions and improve the cellular immune function and renal function.

Immunoregulatory effects of Huaier (Trametes robiniophila Murr) and relevant clinical applications

“…One meta-analysis found significantly elevated IgM level in Huaier-treated patients with hepatocellular carcinoma ( 61 ), which is in agreement with another study investigating the effects of HQH in children with severe Mycoplasma pneumonia ( 13 ). Conversely, for pediatric patients with primary nephrotic syndrome, it has been reported by meta-analysis that the regulation of HQH on IgM level was not statistically significant ( 74 ) in spite of some positive observation ( 82 ). On the other hand, coherent conclusions have been noted that Huaier promoted reduction of serum IgE level in animal models of asthma ( 49 , 80 ) and parasitic infection ( 79 ), indicating amelioration of diseases.…”

“…In rat ADR-induced nephropathy, HQH ameliorated podocyte injury and reduced infiltration of mononuclear macrophages in renal interstitium ( 48 ). Moreover, HQH significantly raised serum IgA, IgG ( 74 ) and IgM ( 82 ) levels in patients with PNS, which probably contributes to the reduction of infection complications ( 74 ). Furthermore, as IL-1β and TNF-α promote glucocorticoid resistance by activating AP-1 that blocks the binding of glucocorticoid-receptor complex with its cognate response element, the IL-1β and TNF-α-lowering effect of HQH suggests its potential in improving glucocorticoid responsiveness of PNS patients ( 48 , 74 , 78 ).…”

“…Evidence suggested that Huaier differentially affects antibody production of various isotypes. HQH remarkably increased serum IgA and IgG in pediatric patients with primary nephrotic syndrome ( 74 , 82 ) and Mycoplasma pneumonia ( 13 ). However, the regulatory effect of Huaier on IgM level is undetermined due to contradictory results of existing literature.…”

“…Pro-inflammatory NF-κB signaling pathway was inhibited in animal ADR-induced nephropathy model by HQH treatment that attenuated p65 and IκBα phosphorylation and nuclear translocation ( 99 ). Clinical and experimental studies unveiled that HQH significantly downregulated the expressions of pro-inflammatory cytokines TNF-α, IFN-γ, IL-1β and IL-18 while upregulated both the serum level and immunosuppressive activity of IL-10 in the context of nephropathy ( 48 , 74 , 82 , 91 ). In rat ADR-induced nephropathy, HQH ameliorated podocyte injury and reduced infiltration of mononuclear macrophages in renal interstitium ( 48 ).…”

Multicenter Real-World Study of Huaiqihuang Granules in the Treatment of Pediatric Henoch-Schonlein Purpura Nephritis

“…A clinical trial of 45 adults has shown that HQH granules alleviate proteinuria and hematuria in patients with mild IgA nephropathy (IgAN) [11]. Another trial of 104 children has shown that HQH granules reduce the occurrence of relapses and adverse events and improve cellular immune function and renal function in children with primary nephrotic syndrome [12]. However, the therapeutic efficacy of HQH for HSPN has only been investigated in small, singlecenter studies.…”