孟鲁司特联合丹参酮对儿童过敏性紫癜患者血清炎症因子的影响及疗效观察

Influence and curative effect of montelukast combined with tanshinone on serum inflammatory cytokines in children with allergic purpura

目的探讨孟鲁司特联合丹参酮对儿童过敏性紫癜(AP)患者血清炎症因子的影响及疔效。方法选取过敏性紫癜患者68例,随机分为中西医组和西医组各34例。两组患儿均予以抗组胺药、钙剂和维生素C等治疗、腹部与关节疼痛明显或消化道出血患儿可加用糖皮质激素治疗,出现肾损害患儿加用予抗血小板聚集药治疗。中西医组加用孟鲁司特联合丹参酮治疗,其中孟鲁司特钠咀嚼片,<6岁、2.5 mg/次,≥6岁,5.0 mg/次,1次/d,连用4周;丹参酮针20 mg加入5%葡萄糖注射液250 mL中静滴、1次/d、连用7 d.西医组单用孟鲁司特治疗、剂量、用法同中西医组。观察两组患儿治疗前后血清炎症因子IL-4、IL-6和TNF-α水平的变化,并比较其治疗效果和不良反应。结果治疗4周后,两组患儿血清IL-4、IL-6和TNF-α水平均较前明显下降(P<0.05或P<0.01).且中西医组下降幅度较西医组更明显(P<0.05);同时中西医组临床总有效率明显优于西医组(χ~2=4.22,P<0.05)。两组患儿治疗中出现不良反应8例,其中西医组3例和中西医组5例,症状相对较轻,两组比较差异无统计学意义(χ~2=0.14,P>0.05)。结论孟鲁司特联合丹参酮对儿童AP患者的疗效确切,安全性较佳,其作用机制与其能明显降低血清IL-4、IL-6和TNF-α水平,从而与调节炎症因子网络紊乱密切相关。

Objective To investigate the influence of montelukast combined with tanshinone on serum inflammatory cy tokines in children with allergic purpura（AP） and its curative effect. Methods 68 patients with allergic purpura were randomly divided into two groups including the traditional Chinese medicine combined with western medicine group and the western medicine group,with 34 cases in each group. Two groups of children were given treatments of antihis- tamines, calcium and vitamin C. Patients with obvious abdominal and joint pain or gastrointestinal bleeding could be added with glucocorticoid treatment, and children with renal damage was given anti-platelet aggregation drugs treat- ment. The Chinese and western medicine group was added with montelukast combined with tanshinone treatment, in- cluding montelukast sodium chewable tablets, 〈6 years old, 2.5 mg/times, ≥〉 6 years old, 5.0 mg/times, 1 time/d, treated for 4 weeks,and tanshinone needle 20 mg adding in 5% glucose injection 250 mL intravenously, 1 time/d, treated for 7d. The Western medicine group was given montelukast treatment alone, and the dose, usage and efficacy was the same as Chinese combined with western medicine group. The levels ofsernm inflammatory factors of IL-4, IL-6 and TNF-α of the two groups were observed before and after treatment, and the therapeutic effect and adverse reactions were com- pared. Results After 4 weeks of treatment, the levels of serum IL-4, IL-6 and TNF-α in the two groups were signifi- cantly lower than those before treatment （P〈0.05 or P〈0.01）, and the descending rate of the Chinese combined with western medicine group was more obvious than those of the western medicine group （P〈0.05）. At the same time, the total effective rate of the patients in the Chinese combined with western medicine group was better than that of the western medicine group （X2=4.22, P〈0.05）. There were 8 cases of adverse reactions in the treatment group,＇ including 3 cases in the western medicine group and 5 eases in the Chinese combined with western medicine group, and the symptoms were relatively light. The difference between the two groups was not statistically significant （X2=0.14, P〉0.05）. Conclusion Montelukast combined with tanshinone is effective and safe in children with AP, and its mechanism is closely related to its ability to significantly reduce serum IL-4, IL-6 and TNF-α levels to regulate the disorder of inflammatory factors.