中西医结合治疗过敏性紫癜和预防肾损害的临床研究

Clinical Study on Integrative Chinese and Western Medicine in Treating Allergic Purpura and Preventing Renal Impairment

目的观察中西医结合治疗过敏性紫癜反复发作和预防肾损害的临床疗效。方法 176例过敏性紫癜患儿随机分成治疗组 (在对照组常规西药治疗基础上加服中药汤剂抗敏消斑饮 7～ 10天 )和对照组 ,在治疗前后检测尿β2 微球蛋白 (β2 MG)和血清免疫球蛋白 (IgA、IgE)指标 ,并观察腹痛、关节痛和紫癜消失的时间。结果治疗组关节肿痛和紫癜消失的时间短于对照组 ,差异有显著性 (P <0 0 1) ,两组治疗前和治疗后 1周尿 β2 MG和血清IgA、IgE差异无显著性 (P >0 0 5 ) ,治疗后 1个月和 6个月尿β2 MG蛋白治疗组低于对照组 ,差异有显著性 (P <0 0 5 ) ,治疗后 1个月血清IgA、IgE治疗组低于对照组 ,差异有显著性 (P <0 0 5 ,P <0 0 1)。 0 5年复发率 :治疗组为 2 3 5 % ,对照组为 4 6 2 % ,两组比较 ,差异有显著性 (P <0 0 1)。结论中西医结合治疗过敏性紫癜可减少紫癜的复发和缩短住院天数 。

Objective To observe the clinical effect in treatment of the recurrent allergic (Henoch Schnlein) purpura and prevention of renal impairment by means of integrative Chinese and Western medicine (ICWM). Methods One hundred and seventy six children with allergic purpura were randomly divided into the treated group (Based on the Western routine therapy of the control group, Kangmin Xiaoban Yin, a kind of TCM decoction, was added for 7～10 days) and the control group. Levels of urinary β 2 microglobulin (β 2 MG) and serum IgA, IgE were measured before and after treatment. And clinical observation on the disappearance time (DT) of abdominal pain, arthralgia and purpura were implemented. Results The DT of joint swelling, arthralgia, and purpura in the treated group was shorter than those in the control group, showing significant difference (P<0 01). Comparison between groups in urinary β 2 MG and serum IgA and IgE before treatment and 1 week after treatment were insignificantly different (P>0 05), but at 1 month and 6 months after treatment, the level of urinary β 2 MG in the treated group was lower than that in the control group, with significant difference (P<0 05), and levels of serum IgA and IgE at 1 month after treatment in the former were lower than those in the control group, also showing significant difference (P<0 05, P<0 01). Six month recurreat rate in the treated group was 23.5%, while that in the control group. There was significant difference in comparison in 1/2 year recurrent rate (P<0 01). Conclusion ICWM in treating allergic purpura could reduce the repeated episodes and shorten the hospitalization time, and effectively prevent the renal impairment of the disease.