儿童腹型过敏性紫癜47例临床分析

Clinical analysis of 47 cases with abdominal type henoch schonlein purpura in children.

目的探讨儿童腹型过敏性紫癜（HSP）的发病、证候、方药及转归等临床特点。方法对2009年1月1日~2010年4月30日在本院住院的47例腹型过敏性紫癜患儿的发病特点、证候分型、方药及转归等方面进行回顾性分析,并与无腹痛症状患者进行比较。结果腹型HSP患儿发病年龄3~12岁42例（89.3%）,发病季节春秋冬39例（83.0%）,发病诱因感染者28例（82.4%）,农村患儿30例（63.83%）。辨证论治血热妄行型38例（83.27%）,生地等12味中药是使用频率高于52.63%的常用药。有腹痛症状和无腹痛症状患儿比较,两组在年龄、性别、过敏史、前驱感染史方面差异无统计学意义,腹痛组混合型显著多于无腹痛组（72.34%比21.05%,P〈0.01）。46例治愈好转（97.87%）。结论腹型HSP发病以8~12岁儿童多见,春秋冬季为主,感染为第一位诱因,农村患儿发病较多,中医辨证以血热妄行型多见,腹痛组混合型显著多于无腹痛组,临床治疗有效率高,预后较好。

Objective To study the clinical characteristics of abdominal type henoch schonlein purpura（HSP） in children.Methods The 47 cases with abdominal type HSP treated from January 1,2009 to April 31,2010 were retrospectively studied and patterns of onset,clinical manifestations,correlated factors of drugs and outcomes were analysed.Then compared with cases of non-abdominal type HSP.Results Of the 47 cases,the onset age from 3~12 were 89.3%.The morbidity of seasons on spring,autumn and winter was 39 cases（83.0%）,The inducing factors were infections（28cases,82.4%）,30 cases（63.83%） were rural children.Compared with non-abdominal type,there was no statistic difference on age,gender,allergy history and infective history.Through zheng differentiation-treatment 38 cases（83.27%） were hemopyretic bleeding type.There were more than 52.63% of high frequent usage in traditional Chinese drug,for example rehmannia root and so on.There were not statistical significance of abdominal type HSP on age,gender,allergic and infective history,but more mixed pattern compared with cases of non-abdominal type（P0.01）.46 cases（97.87%） were cured or greatly improved.Conclusion Abdominal type HSP of the 47 cases,the onset age from 8~12 were common.The morbidity of seasons on spring,autumn and winter was high.The most important inducing factor was infection.The morbidity was high in the rural children.Hemopyretic bleeding type was the most one and there were more mixed pattern compared with cases of non-abdominal type.Clinical therapy was effective and prognosis better.