中西医结合疗法治疗小儿过敏性紫癜的血清免疫学研究

Seroimmunology analysis in traditional Chinese herbal medicine combined with western therapy for infantile allergic purpura

目的探讨中西医结合疗法对小儿过敏性紫癜患者外周血免疫学指标的影响。方法选取本院收治的过敏性紫癜患儿76例,随机分为对照组和观察组各38例,对照组采用常规西药疗法,观察组在对照组的基础上口服自制化瘀降浊汤;分别于治疗前后抽取患儿空腹静脉血,以全自动生化分析仪测定血清免疫球蛋白及补体水平,并采用ELISA试剂盒对Th1辅助细胞分泌因子、Th2辅助细胞分泌因子及Th17辅助细胞分泌因子做定量分析。结果观察组的临床有效率显著高于对照组(P<0.05)。治疗前2组患者在血清免疫球蛋白、补体及细胞分泌因子水平等方面均无显著性差异(P>0.05)。治疗后2组患者免疫球蛋白IgA、IgE,补体C3,Th1辅助细胞分泌因子TNF-α,Th2辅助细胞分泌因子IL-4、IL-6、IL-10及Th17辅助细胞分泌因子IL-17A、IL-17F水平均显著降低,且观察组患者水平显著低于对照组(P<0.05);Th1辅助细胞分泌因子IL-12显著升高,且观察组患者水平显著高于对照组(P<0.05);而免疫球蛋白IgG、IgM,补体C4及Th1辅助细胞分泌因子IFN-γ在治疗前后及各组之间均无显著性差异。结论中西医结合疗法可发挥多靶点、低毒副损伤的优势,通过对多种炎性因子的调整平衡小儿过敏性紫癜患者的体液免疫和细胞免疫功能,有效清除患者血液系统炎性反应和微小血栓,为目前治疗小儿过敏性紫癜的理想策略。

Infantile allergic purpura is a typical immune disease with systemic generalized vasculitis as main pathological changes, which could injury skin, gastrointestinal tract, kidneys, joints, and even more such as heart and brain. Western therapy based on symptomatic and hormonal treatment for the disease shows limited applicability and remarkable side effect. This study designed to observe efficacy of traditional Chinese herbal medicine combined with western therapy on infantile allergic purpura through perspective of immunology, in which 76 cases of infantile allergic purpura patients were randomly divided into control group of 38 cases which were treated with conventional western therapy and observation group of 38 cases which were given oral Chinese herbal medicine on the basis of conventional ways. Fasting venous blood of each patient was extracted and detected for the indexes of immunoglohulin, complement, and cells secrete factors. We found that there was no significant difference （P 〈 0.05） between groups in serum immunoglobulin, complement, and cells secrete factor levels before the treatment. After treatment, indexes of IgA, IgE, C3, TNF-α, IL-4, IL-6, IL-10 and ILl7 level were significantly reduced （P〈 0.05）, and all of them in observation group were significantly lower than that of control group （P 〈 0.05）; but IL-12 level was significantly increased （P〈 0.05） while observation group got the higher level （P〈 0.05）; there was no significant difference in indexes of IgG, IgM, C4 and IFN-α between groups. Our research indicated that the therapy combined with traditional Chinese and western medicine could balance humoral and cellular immunity function through adjust inflammatory factors of pediatric allergic purpura patients, which contributes to inflammatoryremission and excision.