活血化瘀方治疗小儿过敏性紫癜肾炎的疗效观察

Observation on curative effect of Huoxuehuayu prescription for treatment of Henoch-Schonlein purpuranephritis in children

目的 探讨活血化瘀方治疗小儿过敏性紫癜肾炎（HSPN）的临床疗效.方法 选择2016年8月至2017年2月在天津市儿童医院中医科就诊的HSPN患儿60例,按随机分为活血化瘀方组和西医治疗对照组,每组30例.活血化瘀方组给予活血化瘀方加减（五灵脂、蒲黄炭、当归、小蓟、牡丹皮、藕节炭各10 g,茯苓、猪苓、泽泻、荆芥炭各6 g,三七3 g.挟热者加白茅根、淡竹叶,挟湿者加赤小豆、芡实,挟虚者加生黄芪、黄精、何首乌）,每日1剂,每日2次;西医治疗组给予维生素C、氨肽素、氯雷他定糖浆;两组治疗30 d后观察临床体征、实验室指标及临床疗效的变化.结果 活血化瘀方组临床体征皮肤紫癜已消退患者数（13例比10例）、部分消退患者数（12例比9例）和实验室指标隐血〈＋患者数（13例比10例）、24 h尿蛋白定量转为正常患者数（25例比20例）、尿沉渣红细胞〈3个/HP患者数（11例比9例）、尿流式红细胞〈30 个/μL患者数（11例比8例）均较西医治疗对照组明显增加（均P〈0.05））.活血化瘀方组治疗后显效13例,有效12例,无效5例,总有效率83.33%（25例）,西医治疗对照组显效10例,有效9例,无效11例,总有效率63.33%（19例）,活血化瘀方组总有效率明显高于西医对照组,差异有统计学意义（P〈0.05）.结论 活血化瘀方可明显改善HSPN患儿实验室指标及临床体征,提高临床总有效率,疗效确切,值得临床推广.

Objective To investigate the clinical efficacy of Huoxuehuayu liquid in treating children with Henoch-Schonlein purpura nephritis （HSPN）. Methods Sixty children with HSPN admitted to the Department of Traditional Chinese Medicine （TCM） of Tianjin Children＇s Hospital were enrolled, and they were randomly divided into a Huoxuehuayu liquid group and a western medicine control group, 30 cases in each group. In Huoxuehuayu liquid group, modified Huoxuehuayu prescription was given, modification means the ingredients of prescription can be added and subtracted according to patients TCM syndrome manifestations （ingredients of prescription： Faeces Togopteri, carbonized Pollen Typhae, Radix Angelicae Sinensis, Herba Cirsii, Cortex Moutan Radicis, carbonized Nodus Nelumbinis Rhizomatis, each 10 g, Poria, Polyporus Umbellatus, Rhizoma Alismatis, carbonized Herba Schizonepetae, each 6 g, Radix Notoginseng 3 g, in patients accompanied by heat, Rhizoma Imperatae and Herba Lophatheri were added, in patients accompanied by dampness Semen Phaseoli and Semen Euryales were added, and in patients accompanied by deficiency, Radix Astragali seu Hedysari, Rhizoma Polygonati, Radix Polygoni Multiflori were added）,1 dose per day, 2 times a day; in western medicine treatment group, vitamin C, aminopeptin, loratadine syrup were given; after 30 days of treatment in two groups, the changes of clinical signs, laboratory indexes and clinical curative effect were observed. Results After treatment of TCM method as above, the numbers of patients with skin purpura subsided （13 cases vs. 10 cases）, partially subsided （12 cases vs. 9 cases）, with occult blood 〈＋ （13 cases vs. 10 cases）, with 24 hours urinary protein transferring to normal （25 cases vs. 20 cases）, with urine erythrocyte in sediment 〈 3 cells/HP （11 cases vs. 9 cases）, with urinary streaming type red blood cells 〈 30 cells/μL （11 cases vs. 8 cases） in Huoxuehuayu liquid group were higher significantly than those in western medicine control group （all P 〈 0.05）. After treatment, there were 13 cases with marked therapeutic effect, 12 cases with effect and 5 cases without effect, the total therapeutic effect being 83.33% （25 cases） in Huoxuehuayu liquid group; while in western medicine control group, there were 10 cases with marked effect, 9 cases with effect and 11 cases without effect, the total therapeutic effect being 63.33% （19 cases）; total therapeutic effect rate in Huoxuehuayu liquid group was obviously higher than that in western medicine control group, the difference was statistically significant （P 〈 0.05）. Conclusions Huoxuehuayu liquid can obviously improve the laboratory indexes and clinical signs, and elevate the clinical total therapeutic effective rate in treatment of children with HSPN; since the curative effect is definite, it is worthwhile to be used extensively in clinical practice.