愈风消斑汤联合常规西药对风盛血热型过敏性紫癜的临床疗效、免疫功能及安全性研究

Clinical Efficacy, Immune Function and Safety of Using Yufeng Xiaoban Decoction Combined with Conventional Western Medicine in the Treatment of Wind-excess Blood-heat Type Henoch Schonlein Purpura

目的:观察愈风消斑汤联合常规西药对风盛血热型过敏性紫癜(HSP)的临床疗效、免疫功能及安全性研究。方法:选取2017年4月~2019年4月定西市临洮县中医院收治的风盛血热型HSP患者86例,按数字表法随机分为对照组(n=43,常规西药治疗)和研究组(n=43,常规西药+愈风消斑汤治疗)。比较两组临床疗效、临床症状消退时间、免疫功能、中医证候评分、不良反应及复发情况。结果:研究组治疗后临床治疗总有效率为88.37%(38/43),高于对照组的69.77%(30/43)(P<0.05);治疗后,研究组临床症状腹痛、皮肤紫癜、关节肿痛消退时间均较对照组短(P<0.05);治疗后,研究组CD_(4)^(+)CD_(25)^(+)Foxp(3)^(+)Treg/CD_(4)^(+)T比值较对照组升高(P<0.05);治疗后,研究组中医证候腹痛、紫癜形态、肢体困重、关节肿痛、紫癜分布评分低于对照组(P<0.05);治疗期间,对比两组不良反应发生率比较,差异无统计学意义(P>0.05);随访期间研究组的复发次数、复发率均较对照组低(P<0.05)。结论:风盛血热型HSP患者采用愈风消斑汤联合常规西药治疗具有较好的临床疗效,可调节免疫功能,改善腹痛、皮肤紫癜等临床症状,降低中医证候评分,缩短病程,安全性高,并可降低患者的复发率。

Objective:To explore the clinical efficacy,immune function and safety of using Yufeng Xiaoban Decoction combined with conventional western medicine in the treatment of henoch schonlein purpura(HSP)of wind-excess blood-heat type.Methods:A total of 86 patients with wind-excess blood-heat type HSP who were admitted to our hospital from April 2017 to April 2019 were selected,and randomly divided into a controlled group(n=43,conventional western medicine treatment)and a study group(n=43,conventional western medicine treatment+Yufeng Xiaoban Decoction treatment)by the number table method.The clinical efficacy,time of clinical symptom regression,immune function,traditional Chinese medicine syndrome score,adverse reactions and recurrence of two groups were compared.Results:The total effective rate of the study group was 88.37%(38/43),which was higher than 69.77%(30/43)of the controlled group(P<0.05).After treatment,the regression time of clinical symptoms of abdominal pain,skin purpura and arthrosis of the study group were shorter those of the controlled group(P<0.05).After treatment,the ratio of CD_(4)^(+)CD_(25)^(+)Foxp(3)^(+)Treg/CD_(4)^(+)T of the study group was higher than that of the controlled group(P<0.05).After treatment,the scores of traditional Chinese medicine syndromes such as abdominal pain,purpura form,limb pain,joint pain,purpura distribution of the study group were lower than those of the controlled group(P<0.05).During treatment,there were no statistical differences in the incidence of adverse reactions between the two groups(P>0.05).The recurrence number and recurrence rate of the study group were lower than those of the controlled group(P<0.05).Conclusion:The treatment of patients with wind-excess blood-heat type HSP are used Yufeng Xiaoban Decoction combined with conventional western medicine has a good clinical efficacy,which can regulate the immune function,improve the clinical symptoms such as abdominal pain and skin purpura,reduce the traditional Chinese medicine syndrome score,shorten the course of disease,have high safety,and wihch can reduce the recurrence rate of patients.