消斑汤治疗风热伤络型儿童过敏性紫癜的疗效及对血清IL-23、IL-18、TNF-α水平的影响观察

Effect of Using Xiaoban Decoction in the Treatment of Children with Wind-Heat Injuring Collaterals Type Allergic Purpura on Prognosis, Levels of Serum IL-23, IL-18and TNF-α

目的:研究风热伤络型儿童过敏性紫癜患儿使用消斑汤治疗后对预后及血清IL-23、IL-18、TNF-α水平的影响。方法:选择我院2015年5月至2018年5月儿科门诊就诊过敏性紫癜患儿112例,随机分为观察组和对照组各56例。对照组采用常规西药治疗(抗过敏、减少毛细血管扩张等),观察组在对照组基础上给予消斑汤治疗,两组患儿均以4周为1个疗程,共治疗3个疗程,并在用药开始后7d/次复诊,追踪随诊12周,停药后继续随访6周。观察治疗前后血清白细胞介素-23(IL-23)、白细胞介素-18(IL-18)、肿瘤坏死因子-α(TNF-α)、免疫球蛋白M(IgM)、免疫球蛋白G(IgG)、免疫球蛋白A(IgA)水平,治疗结束后紫癜、腹痛、关节肿痛、血尿消失时间,统计临床疗效及复发率,记录药物不良反应。结果:观察组治疗后血清IL-23、IL-18、TNF-α水平改善情况均优于对照组(P<0.05)。观察组治疗后血清IgM、IgG、IgA水平改善情况均优于对照组(P<0.05)。观察组治疗后紫癜、腹痛、关节肿痛、血尿消失时间均低于对照组(P<0.05)。观察组治疗后总有效率为96.42%,高于对照组82.14%(P<0.05);观察组治疗结束后随访6周复发率为5.36%,低于对照组17.86%(P<0.05)。两组患儿治疗后药物不良反应差异无统计学意义(P>0.05)。结论:消斑汤治疗风热伤络型儿童过敏性紫癜对患儿疗效显著,能有效改善血清炎症因子水平,提高机体体液免疫功能,安全可靠,且复发率较低。

Objective:To study the effect of using Xiaoban Decoction in the treatment of children with wind-heat injuring collaterals type allergic purpura on prognosis, levels of serum IL-23, IL-18 and TNF-α.Methods:A total of 112 children with allergic purpura who were treated in pediatric outpatient from May 2015 to May 2018 were enrolled.They were randomly divided into observation group and controlled group, 56 cases in each group.The controlled group was treated with routine western medicine(anti-allergy, reducing telangiectasia, etc.).On this basis, the observation group was given Xiaoban Decoction.4 weeks was defined as a course of treatment.They were treated for 3 courses.After medication, subsequent visit was conducted 7 days/once.The follow-up clinic lasted for 12 weeks.The follow-up lasted for 6 weeks after drug withdrawal.The levels of serum interleukin-23(IL-23), interleukin-18(IL-18), tumor necrosis factor-α(TNF-α), immunoglobulin M(IgM), immunoglobulin G(IgG) and immunoglobulin A(IgA) before and after treatment, disappearance time of purpura, abdominal pain, joint swelling and pain and hematuria after treatment were observed.The clinical curative effect and recurrence rate were statistically analyzed.The adverse drug reactions were recorded.Results:After treatment, improvement of serum IL-23, IL-18 and TNF-α levels in the observation group was better than that in the controlled group(P<0.05).After treatment, improvement of serum IgM, IgG and IgA levels in the observation group was better than that in the controlled group(P<0.05).After treatment, disappearance time of purpura, abdominal pain, joint swelling and pain and hematuria in the observation group were lower than those in the controlled group(P<0.05).After treatment, the total response rate in the observation group was higher than that in the controlled group(96.42% vs 82.14%)(P<0.05).After treatment, the recurrence rate in the observation group was lower than that in the controlled group by 6-week follow-up(5.36% vs 17.86%)(P<0.05).After treatment, there was no significant difference in adverse drug reactions between the two groups(P>0.05).Conclusion:The curative effect of Xiaoban Decoction is significant on children with wind-heat injuring collaterals type allergic purpura, which can effectively improve levels of serum inflammatory factors, and improve humoral immune function.It is safe and reliable, and the recurrence rate is low.