愈风消斑汤治疗风盛血热型过敏性紫癜疗效观察

Efficacy of Yufeng Xiaoban Decoction on Treating Patients with Henoch-Schonlein Purpura of Excess Wind and Blood Heat Type

目的：观察愈风消斑汤治疗风盛血热型过敏性紫癜疗效。方法：随机选择2013年6月—2016年6月于我院进行过敏性紫癜治疗的患者60例进行临床研究。使用随机数字表法将患者分为观察组和对照组各30例。对照组患者给予盐酸左西替利嗪片5 mg,日1次,口服,共计21 d,伴有便血症状的患者加用甲强龙40 mg,日1次。观察组在对照组治疗方案基础上给予中药方剂愈风消斑汤进行治疗。观察两组患者治疗前后证候评分变化、外周血CD4＋CD25＋Foxp3＋Treg/CD4＋T变化、临床疗效、临床症状消退时间以及复发情况。结果：两组患者治疗后证候与治疗前相比均明显降低,且观察组评分明显低于对照组,统计学差异明显（P〈0.05）;观察组总有效率为96.67%,明显高于对照组73.33%,且具有统计学差异（P〈0.05）;两组患者治疗后CD4＋CD25＋Foxp3＋Treg/CD4＋T比值较治疗前均有所升高,但观察组明显高于对照组,且组间差异明显（P〈0.05）;观察组患者皮肤紫癜、腹痛、关节肿痛等临床症状消失时间均明显短于对照组,观察组复发率为16.67%,明显低于对照组46.67%,观察组复发次数也明显低于对照组,均具有统计学差异（P〈0.05）。结论：愈风消斑汤对于风盛血热型过敏性紫癜具有良好的临床疗效,能够改善患者临床症状,缩短病程,提高临床疗效,降低复发率。

Objective：To observe the efficacy of Yufeng Xiaoban Decoction on treating patients with Henoch-Schonlein purpura of excess wind and blood heat type. Methods：A total of 60 qualified patients according to inclusion and exclusion criteria treated in our hospital from June 2013 to June 2016 were enrolled in this clinical study. Patients were divided into control group（n=30）and treatment group（n=30）by random number table to receive 21 days of treatment with levocetirizine hydrochloride tablets（5 mg,once daily,p.o.）or Yufeng Xiaoban Decoction plus the therapy of control group,respectively. Methylprednisolone（40 mg,once daily）was allowed to be used in patients occurred hematochezia. The post-to pre-treatment change of syndrome score and CD4＋ CD25＋ Foxp3＋ Treg/CD4＋ T level in peripheral blood,clinical efficacy,the time to clinical symptom resolution and recurrence of disease were observed. Results：The syndrome score was significantly decreased after treatment in both groups,with a higher decrease in treatment group compared to control group（P〈0.05）;The total effective rate was significantly increased in treatment group（96.67% vs 73.33%,P〈0.05）. Although an increase of CD4＋ CD25＋ Foxp3＋ Treg/CD4＋ T level was observed after treatment in both groups,the level of this marker was significantly higher in treatment group relative to the control group（P〈0.05）. Also,the clinical symptoms of purpura,abdominal pain and joint swelling was resolved sooner in treatment group. The recurrent disease occurred in 16.67% of patients in treatment group,which was significantly less than that of patients in control group（46.67%,P〈0.05）. Conclusion：Yufeng Xiaoban Decoction could provide clinical benefits in patients with Henoch-Schonlein purpura of excess wind and blood heat type,presented by improved clinical symptoms,decreased course of disease,improved total effective rate and declined recurrence rate when was given in addition to levocetirizine hydrochloride.