黄芪冲剂治疗儿童过敏性紫癜作用的研究

目的 探讨黄芪对过敏性紫癜的作用机制和对减少过敏性紫癜复发的作用。方法确诊为过敏性紫癜未经治疗的146例患儿随机分成两组：一组给予抗过敏药物治疗，另一组在此基础上加黄芪冲剂治疗。用流式细胞仪分别检测两组治疗前、治疗后（1个月）外周血T淋巴细胞（CD3＋、CD4＋、CD8＋、CD4＋CD25＋）及细胞因子（IL-4、IL-6、IFN-γ、TNF等）的表达水平变化，并与健康儿童作对比。结果随访3—6个月，黄芪治疗组呼吸道感染明显减少者占92．3％，一般治疗组占76．2％，二者差异有统计学意义（x^2=6．121，P=0．013）；黄芪治疗组过敏性紫癜复发率明显低于一般治疗组（分别为31．43％，49．15％；x^2=4．207，P=0．040）；过敏性紫癜患儿及一般治疗组血IL-6、TNF—α水平较健康儿童上升，而黄芪治疗组与健康儿童比较差异无统计学意义。结论黄芪能调节过敏性紫癜患儿的T细胞功能，可有效减少过敏性紫癜的复发，对改善过敏性紫癜的预后有重要意义。

Objective Treatment of children with Astragalus root for schonlein purpura can be a significant challenge for pediatric nephrologist because of recurrent purpura. Astragalus root were administered to the children with Sehonlein purpura in present study to evaluate its protective effects in these patients. Methods 146 children with sehonlein purpura were randomly divided into two groups： control group： with normal anti -histamine reagent Loratadin; while in Astragalus root group patients were administered with Astragalus root simultaneously. T lymphocyte subgroup, serum concentration of IL- 4,IL- 6,IFN -γ and TNF were measured in both groups and patients were followed for 3 - 6 months. Results After 3 - 6 months follow - up, the percentage of patients with reduced upper respiratory tract infection in Astragalus root group was much more than the percentage in control （92. 3% vs 76. 2% , X2 = 6. 121 ,P = 0. 013）. The recurrent rate of purpura in Astragalus root group was less than in controls （31.43% vs 49.15% , X2 =4. 207,P ：0. 040）. Compared with normal children, the serum concentration of IL - 6 TNF - a was significantly elevated in Henoch schonlein purpura and control group, while there was no significant difference between Astragalus root group and normal children. Conclusions Astragalus root is effective in control of the recurrent purpura, T lymphocyte dysfunction, and for the improvement of the prognosis in children with Henoch Schonlein purpura.