中西医联合治疗对儿童过敏性紫癜的临床疗效及外周血中细胞因子水平的影响

Therapeutic effects western medicine combined with Qingrequshi Hezhongzhixue prescriptions on anaphylactoid purpura in children and its effects on levels of cytokines in peripheral blood of patients

目的探讨西医联合"清热祛湿,和中止血"方剂对儿童过敏性紫癜的临床疗效及外周血细胞因子水平的影响。方法选取2016年1月至2017年6月收集就诊的152例过敏性紫癜患儿作为研究对象,随机分为2组。其中,联合方剂治疗组患儿60例,在常规西医治疗的基础上给予"清热祛湿,和中止血"方剂治疗;西医对照组患儿92例,给予常规抗感染、抗过敏及对症治疗。记录、比较2组患儿临床症状持续时间、治疗效果及治疗前后血清中降钙素原(procalcitonin,PCT)、C-反应蛋白(C-reactive protein,CRP)及IL-8、TNF-α、ICAM水平。结果 2组患儿入院时性别比、年龄、临床症状病情及血清中PCT、CRP及IL-8、TNF-α、ICAM表达水平等方面差异无统计学意义(P>0.05),2组间具有可比性。治疗完成后,与西医对照组比较,联合方剂治疗组患儿血清中CRP及IL-8、TNF-α、ICAM表达水平降低,且差异有统计学意义(P<0.05或P<0.01)。联合方剂治疗组临床症状持续时间显著低于西医对照组(P<0.05或P<0.01);其治疗总有效率(95.00%)显著高于西医对照组总有效率(88.04%)(P=0.009);其显效率及有效率均高于西医对照组,整体治疗效果显著较高(P=0.010)。结论在给予过敏性紫癜患儿西医常规治疗的同时,给予"清热祛湿,和中止血"方剂治疗可降低患儿外周血中CRP及IL-8、TNF-α、ICAM细胞因子水平,缩短临床症状持续时间,提高临床治疗效果,该治疗方案值得在临床推广应用。

Objective To investigate the therapeutic effects of western medicine combing Qingrequshi Hezhongzhixue prescriptions on henoch-schonlein purpura(HSP)in children and its effects on levels of cytokines in peripheral blood of patients.Methods A total of 152 children patients with HSP who were treated in our hospital from March 2016 to March 2017 were randomly divided into combination treatment group(n=60)and control group(n=92).The patients in control group were treated by anti-infective,anti-allergy and symptomatic treatment,however,the patients in combination treatment group,on the basis of of control group,were treated by Qingrequshi Hezhongzhixue prescriptions.The therapeutic effects,duration of clinical symptoms,the serum levels of procalcitonin(PCT),C-reactive protein(CRP),IL-8,TNF-αand ICAM before and after treatments were observed and compared between two groups.Results On admission there were no significant differences in patient’s gender and age,clinical symptoms and serum levels of IL-8,TNF-αand ICAM between two groups(P>0.05).After treatment,the serum levels of CRP,IL-8,TNF-αand ICAM in combination treatment group were significantly lower than those in control group(P<0.05 or P<0.01).Moreover the duration of clinical symptoms in combination treatment group was significantly shorter than that in control group(P<0.05),and the total effective rate(95%)in combination treatment group was significantly higher than that(88.04%)in control group(P<0.05).In additon the excellence eare and effective rate in combination treatment group were significantly higher than those in control group(P<0.05).Conclusion The western medicine combined with Qingrequshi Hezhongzhixue prescriptions in treatment of HSP can improve therapeutic effects and decrease the serum levels of CRP,IL-8,TNF-α,ICAM,which can also shorten duration of clinical symptoms,therefor,which is worth using widely in clinical;practice.