中医辨证联合西医治疗儿童过敏性紫癜的疗效及对免疫球蛋白的影响

Curative effect of Chinese medicine differentiation combined western medicine on allergic purpura in children and the effect on immune globulin

目的探讨中医辨证联合西医治疗儿童过敏性紫癜的临床疗效及对免疫球蛋白的影响。方法将过敏性紫癜患儿104例随机分为研究组和对照组各52例。研究组给予中医辨证联合西医常规治疗,对照组给予单纯西医常规治疗,2组均以4周为1个疗程。检测2组治疗前后血清免疫球蛋白(IgG、IgA)水平和尿常规,观察2组临床疗效和不良反应发生情况,随访观察2组复发率。结果研究组总有效率明显高于对照组(P<0.05);研究组各中医证型的总有效率比较差异无统计学意义。治疗后2组血清IgA、IgG水平及尿常规RBC、WBC计数,RBC、WBC高倍视野,隐血,尿蛋白分布情况均较治疗前明显改善(P均<0.05),且研究组改善情况明显优于对照组(P<0.05)。2组均未发生严重不良反应。随访6个月时研究组的复发率明显低于对照组(P<0.05)。结论中医辨证联合西医治疗儿童过敏性紫癜能显著提高治疗效果,降低复发率,且安全性较高,其作用机制可能与调节免疫球蛋白水平、抑制抗原抗体反应有关。

Objective It is to explore the curative effect of Chinese medicine differentiation combined western medicine on allergic purpura in children and the effect on immune globulin. Methods 104 cases of allergic purpura children were randomly divided into research group and the control group, each group had 52 cases. The research group was treated with Chinese med- icine differentiation combined with western medicine therapy, while the control group was given simple western medicine rou- tine treatment, The period of treatment was 4 weeks in both groups. The serum immunoglobulin （ IgG, IgA） level and urinaly- sis before and after treatment were determined in both groups, the clinical curative effect and occurrences of side effects were observed, the recurrence of the two groups was followed up. Results The total effective rate of the researsh group was higher than that of the control group （P 〈 0.05 ） ;There was no significant difference in the total effective rate of TCM syndrome a- mong every syndrome type in the research group （P 〉0.05） ; The levels of serum IgA, IgG, RBC, WBC count, RBC, WBC high power field of vision, occult blood, urine protein distribution of the two groups after treatment were obviously improved （P 〈 0. 05 ） , and the improvements of the researsh group were better than that of control group （ P 〈 0.05 ） ; There were no serious adverse reaction happened in the two groups; Followed up for 6 months, the recurrence rate of the research group was signifi- cantly lower than that of the control group （P 〈 0.05 ）. Conclusion Traditional Chinese medicine differentiation combined western medicine can significantly improve the clinical effect in treatment of allergic purpura in children, decrease the recur- rence rate, and has high security, its mechanism may be related to regulating immune globulin level, inhibiting the antigen-an- tibody reaction.