犀角地黄汤治疗儿童过敏性紫癜血热妄行证临床疗效及对免疫功能影响

Clinical Efficacy of Xijiao Dihuang Decoction(犀角地黄汤)on Children of Henoch-Schonlein Purpura with Blood Heat Syndrome and Influence on Immune Function

目的观察犀角地黄汤辅助西医治疗儿童过敏性紫癜(HSP)血热妄行证的临床疗效以及对免疫功能的影响。方法选取2018年3月—2019年12月收治的140例HSP血热妄行证患儿,按照随机数字表法将其随机分为观察组和对照组,每组各70例。对照组采用常规西医治疗,观察组在此基础上联合犀角地黄汤治疗,两组患儿均连续用药14 d。记录两组患儿治疗前后中医证候积分,检测两组患儿治疗前后体液免疫指标[免疫球蛋白A(IgA)、IgG、IgM]、细胞免疫指标(CD_(4)^(+)、CD_(8)^(+)、CD_(4)^(+)/CD_(8)^(+))以及血清学指标[肿瘤坏死因子-α(TNF-α)、转化生长因子-β1(TGF-β1)]水平。结果观察组临床有效率(85.71%)明显高于对照组(70.00%),差异具有统计学意义(P<0.05)。治疗后两组患儿的中医证候积分与血清IgA、IgM、CD_(4)^(+)、CD_(4)^(+)/CD_(8)^(+)、TNF-α、TGF-β1水平较治疗前明显降低(P<0.05),且观察组的下降作用明显优于对照组(P<0.05)。治疗后两组患者的血清IgG、CD_(8)^(+)水平较治疗前明显升高(P<0.05),且观察组的上升作用明显优于对照组(P<0.05)。结论犀角地黄汤辅助西医治疗HSP血热妄行证患儿能够有效改善临床症状,降低血清TNF-α、TGF-β1水平,调节体液免疫与细胞免疫,整体疗效确切,具有临床推广应用价值。

Objective To observe the clinical efficacy of Xijiao Dihuang Decoction(犀角地黄汤,XJDHT)combined with Western medicine on children of Henoch-Schonlein purpura(HSP)with blood heat syndrome and influence on immune function.Methods 140 patients of HSP with blood heat syndrome in the Benxi hospital of traditional Chinese medicine from March 2018 to December 2019 were randomly divided into the XJDHT observation group and the Western medicine control group,70 cases in each group.Patients in the Western medicine control group were treated with conventional Western medicine.Patients in the XJDHT observation group were treated with Xijiao Dihuang Decoction on the basis of the Western medicine control group.Patients in two groups were treated for 14 days.The TCM syndrome score was recorded before and after treatment between two groups.Humoral immunity indexes[immunoglobulin A(IgA),IgG,IgM],cellular immunity indexes(CD_(4)^(+),CD_(8)^(+),CD_(4)^(+)/CD_(8)^(+))and serological indexes[tumor necrosis factor-α(TNF-α),transforming growth factor(TGF-β1)]levels were tested before and after treatment between two groups.Results The total effective rate of the XJDHT observation group(85.71%)was significantly higher than the Western medicine control group(70.00%,P<0.05).After treatment,the TCM syndrome score and serum IgA,IgM,CD_(4)^(+),CD_(4)^(+)/CD_(8)^(+),TNF-α,TGF-β1 levels in two groups were significantly lower than those before treatment(P<0.05),and the descending effect trend in the XJDHT observation group was better than the Western medicine control group(P<0.05).After treatment,serum IgG and CD_(8)^(+)levels in two groups were significantly higher than those before treatment(P<0.05),and the ascending effect trend in the XJDHT observation group was better than the Western medicine control group(P<0.05).Conclusion Xijiao Dihuang Decoction combined with Western medicine on children of HSP with blood heat syndrome can effectively improve clinical symptoms,reduce serum TNF-αand TGF-β1,regulate humoral immunity and cellular immunity.The overall effect is accurate,which has clinical application value.