滋阴凉血化瘀止血方辨证加味治疗小儿过敏性紫癜性肾炎37例

Clinical Efficacy of Modified Yin-nourishing,Blood-cooling,Stasis-resolving,and Hemostasis Prescription in Syndrome Differentiation-based Treatment of Henoch-Schnlein Purpura Nephritis in Children:A Report of 37 Cases

目的观察滋阴凉血化瘀止血基本方辨证加味治疗小儿过敏性紫癜性肾炎(Henoch Schnlein purpura nephritis,HSPN)的临床疗效及其对患者凝血功能的影响。方法将67例小儿HSPN患者随机分为中药组(n=37)和西药组(n=30),中药组患者口服滋阴凉血化瘀止血基本方的辨证加味方,西药组患者接受常规西药治疗。连续治疗30d后,观察两组临床疗效及凝血功能的变化。结果中药组临床疗效显著优于西药组(P<0.05);中药组不同证型的疗效比较,差异无统计学意义(P>0.05)。治疗后两组血小板(platelet,PLT)计数、血浆纤维蛋白原(fibrinogen,Fib)均显著降低(P<0.05),凝血时间(clotting time,CT)、血浆前凝血酶原时间(prothrombin time,PT)和活化部分凝血活酶时间(activated partial thromboplastin time,APTT)均显著升高(P<0.05)。治疗组CT变化率大于对照组(P<0.05),PT变化率小于对照组(P<0.05),两组PLT、APTT、Fib变化率比较,差异均无统计学意义(P>0.05)。结论在滋阴凉血化瘀止血基础上辨证治疗小儿HSPN,其临床疗效优于西医常规疗法,两者对凝血功能的改善作用相当。

Objective To observe the clinical efficacy of modified yin-nourishing, blood-cooling, stasis-re- solving, and hemostasis prescription （YBSHP） in the syndrome differentiation-based treatment of Henoch- Sch nlein purpura nephritis （HSPN） in children and its effect on the coagulation function of patients. Methods Sixty-seven children with HSPN were randomly divided into traditional Chinese medicine （TCM） group （n=37） and Western medicine （WM） group （n=30）. The TCM group was orally given modified YBSHP, while the WM group received conventional WM treatment. The course of treatment was 30 d for both groups. The treatment outcome and coagulation function were compared between the two groups. Results The TCM group had a significantly better treatment outcome than the WM group （P〈 0.05） ; there were no significant differences in treatment outcome between the patients in TCM group with different syndromes （P〉0. 05）. After treatment, both groups showed significant decreases in platelet count （PLT） and plasma fibrinogen （Fib） （P〈0.05） but significant increases in clotting time （CT）, pro- thrombin time （PT）, activated partial thromboplastin time （APTT） （P〈0.05） ; compared with the con- trol group, the treatment group had a significantly higher increase in CT （P〈0.05） but a significantly lower increase in PT （P〈0.05） ; there were no significant differences in the changes in PLT, APTT, and Fib between the two groups （P〉0.05）. Conclusion For children with HSPN, modified YBSHP for syn- drome differentiation-based treatment has better clinical efficacy than conventional WM treatment, and the two therapies are comparable in improving coagulation function.