复方甘草酸苷用于过敏性紫癜治疗的临床效果与安全性

Clinical efficacy and safety of compound glycyrrhizin in the treatment of Henoch-Schonlein purpura

目的观察复方甘草酸苷用于过敏性紫癜治疗的临床效果与安全性。方法选取2018年1月—2021年1月江苏省泗洪县第一人民医院收治的过敏性紫癜患儿80例,采用随机数字表法分为观察组和对照组,各40例。对照组患儿予常规综合治疗,观察组在对照组基础上加用复方甘草酸苷注射液治疗,2组均治疗1周。比较2组治疗效果、临床症状(腹痛、消化道症状、血尿蛋白尿、皮肤症状、关节症状、肾损害等)改善及住院时间,治疗前后血液流变学指标[血液黏度、红细胞沉降率(ESR)、红细胞聚集指数(VAI)、红细胞变形指数(TK)]、血清免疫球蛋白(IgA、IgG、IgM)水平、血清炎性因子指标[白介素-4(IL-4)、白介素-7(IL-7)、干扰素-γ(IFN-γ)]变化及不良反应。结果观察组患儿治疗总有效率为95.00%,高于对照组的67.50%(χ^(2)=9.928,P=0.002);观察组患儿各项临床症状消失时间及住院时间均短于对照组(P<0.01);治疗2周后,2组血液黏度、ESR、VAI及IgA、IgG、IgM、IL-4、IL-7、IFN-γ水平均较治疗前下降,TK较治疗前上升,且观察组下降或上升幅度大于对照组(P均<0.01);2组不良反应总发生率比较差异无统计学意义(7.50%vs.15.00%;χ^(2)=1.127,P=0.288)。结论复方甘草酸苷用于过敏性紫癜治疗的临床效果肯定,可有效缩短患儿症状改善时间,对其免疫指标发挥显著正向调节作用,降低炎性反应程度,同时不会增加不良反应发生风险,值得临床推广应用。

Objective To observe the clinical effect and safety of compound glycyrrhizin in the treatment of Henoch-Schonlein purpura.Methods Eighty children with Henoch-Schonlein purpura treated in The First People's Hospital of Sihong County in Jiangsu Province from January 2018 to January 2021 were randomly divided into observation group and control group,with 40 cases in each group.The children in the control group were treated with routine comprehensive treatment,and the observation group was treated with compound glycyrrhizin Injection on the basis of the control group.Both groups were treated for 1 week.The treatment effect,the time of improvement of clinical symptoms(including abdominal pain,gastrointestinal symptoms,hematuria,proteinuria,skin symptoms,joint symptoms,renal damage,etc.)and the time of hospitalization were compared between the two groups.At the same time,the changes of hemorheological indexes(blood viscosity,ESR,VAI,TK),serum immunoglobulin(IGA,IgG,IgM)and serum inflammatory factor indexes(IL-4,IL-7,IFN-γ)and the occurrence of adverse reactions were compared between the two groups before and after treatment.Results The total effective rate of the observation group was 95.00%,higher than 67.50% of the control group(χ^(2)=9.928,P=0.002).The time of disappearance of clinical symptoms and hospitalization in the observation group were shorter than those in the control group(P<0.01).After 2 weeks of treatment,the levels of blood viscosity,ESR,VAI,IgA,IgG,IgM,IL-4,IL-7 and IFN-γin the two groups decreased compared with those before treatment,and the level of TK increased compared with those before treatment,and the decrease or increase range of the observation group was greater than that of the control group(P<0.01).There was no significant difference in the total incidence of adverse reactions between the two groups(7.50%vs.15.00%;χ^(2)=1.127,P=0.288).Conclusion The clinical effect of compound glycyrrhizin in the treatment of Henoch-Schonlein purpura is positive.It can effectively shorten the time of symptom improvement,play a significant positive regulatory role in its immune indexes,reduce the degree of inflammatory reaction,and will not increase the risk of adverse reactions.It is worthy of clinical application.