摘要
目的评价解毒化斑汤结合孟鲁司特钠咀嚼片治疗儿童过敏性紫癜(henoch-sch enlein purpura,HSP)血热妄行证的疗效。方法将符合入选标准的2017年1月-2019年12月本院HSP血热妄行证患儿80例,按随机数字表法分为2组,每组40例。对照组睡前顿服孟鲁司特钠咀嚼片,研究组在对照组基础上加服解毒化斑汤。2组均连续治疗2周。观察患儿消化道病变、皮肤紫癜、肾脏病变、关节肿痛消失时间;分别于治疗前后进行皮肤紫癜改善评分;采用ELISA法检测血清IL-6、IL-4、干扰素-g(Interferon-g,IFN-g)、TNF-a水平,采用散射比浊法测定IgG、IgA、IgM水平及T淋巴细胞亚群(CD4^(+)、CD8^(+))水平,计算CD4^(+)/CD8^(+)比值,评价临床疗效。结果研究组总有效率为87.5%(35/40)、对照组为67.5%(27/40),2组比较差异有统计学意义(χ^(2)=4.588,P=0.032)。研究组治疗后消化道病变、皮肤紫癜、肾脏病变、关节肿痛消失时间均早于对照组(t值分别为7.802、12.167、7.309、9.365,P值均<0.001);研究组治疗后血清IL-6、IL-4、IFN-g、TNF-a水平均低于对照组(t值分别为9.319、6.738、8.221、6.553,P值均<0.001);研究组治疗后1周[(2.75±0.69)分比(3.92±0.83)分,t=6.856]、治疗后2周[(0.41±0.15)分比(1.55±0.37)分,t=18.095]皮肤紫癜改善评分均低于对照组(P<0.01);研究组治疗后IgG、CD4^(+)水平及CD4^(+)/CD8^(+)比值均高于对照组(t值分别为5.160、4.558、3.442,P值均<0.01),IgA、IgM、CD8^(+)水平均低于对照组(t值分别为2.614、6.712、5.468,P值均<0.05)。治疗期间,对照组不良反应发生率为17.5%(7/40)、研究组为15.0%(6/40),2组比较差异无统计学意义(χ^(2)=0.092,P=0.762)。结论解毒化斑汤结合孟鲁司特钠咀嚼片可有效改善HSP血热妄行证患儿的临床症状,减轻炎症反应,提高机体免疫力,且安全性较好。
Objective To evaluate the efficacy of Jiedu-Huaban Decoction combined with montelukast sodium chewable tablets in the treatment of children with henoch schonlein purpura(HSP).Methods A total of 80 children with HSP and blood heat syndrome who met the inclusion criteria,from January 2017 to December 2019,were randomly divided into two groups by random number table method,40 in each group.The control group took montelukast sodium chewable tablets at night,and the study group took Jiedu-Huaban Decoction on the basis of the control group.Both groups were treated for 2 weeks.The disappearance time of gastrointestinal disease,skin purpura,kidney disease,joint swelling and pain were observed.The improvement score of skin purpura was evaluated before and after treatment.The serum levels of IL-6,IL-4,interferon-g(IFN-g)and TNF-αwere detected by ELISA,and the levels of IgG,IgA and IgM.The T lymphocyte subsets(CD4^(+)and CD8^(+))were measured by nephelometry,and the CD4^(+)/CD8^(+)values were calculated.The clinical efficacy was evaluated.Results The total effective rate was 87.5%(35/40)in the study group and 67.5%(27/40)in the control group,with significant difference between the two groups(χ^(2)=4.588,P=0.032).The disappearance time of gastrointestinal disease,skin purpura,kidney disease and joint swelling and pain in the study group were significantly earlier than those in the control group(t=7.802,12.167,7.309,9.365,all Ps<0.001).After treatment,the serum levels of IL-6,IL-4,IFN-g and TNF-αin the study group were significantly lower than those in the control group(t=9.319,6.738,8.221,6.553,all Ps<0.001).The improvement score of skin purpura at 1 week after treatment(2.75±0.69 vs.3.92±0.83,t=6.856)and 2 weeks after treatment(0.41±0.15 vs.1.55±0.37,t=18.095)in the study group were significantly lower than those in the control group(P<0.01).After treatment,the level of IgG,CD4^(+),CD4^(+)/CD8^(+)in the study group were significantly higher than those in the control group(t=5.160,4.558,3.442,all Ps<0.01),the level of IgA,IgM,CD8^(+)in the study group were significantly lower than those in the control group(t=2.614,6.712,5.468,all Ps<0.05).During the treatment,the incidence of adverse reactions in the control group was 17.5%(7/40),and that of the study group was 15.0%(6/40),wherer there was no statistical difference between the two groups(χ^(2)=0.092,P=0.762).Conclusion Jiedu-Huaban Decoction combined with montelukast sodium chewable tablets can improve the clinical symptoms of children with HSP and blood heat syndrome,reduce the body inflammatory reaction,improve immunity,with good safety.
作者
宫雅杰
储王燕
李晓静
Gong Yajie;Chu Wangyan;Li Xiaojing(Department of Pediatrics,Taihe County Hospital of Traditional Chinese Medicine,Fuyang 236000,China)
出处
《国际中医中药杂志》
2021年第8期757-762,共6页
International Journal of Traditional Chinese Medicine
基金
安徽省中医药科研课题(2017zy041)。
关键词
紫癜
过敏性
儿童
紫癜·血热妄行证
解毒化斑汤
孟鲁司特钠咀嚼片
免疫力
Purpura,Schoenlein-Henoch
Child
Purpura with syndrome of bleeding due to blood heat
Jiedu-Huaban Decoction
Montelukast sodium chewable tablets
Immunity
