氯雷他定联合孟鲁司特钠片治疗过敏性紫癜的临床研究

Clinical study of loratadine combined with montelukast sodium tablets in the treatment of Henoch-Schönlein purpura

目的探讨氯雷他定联合孟鲁司特钠片治疗过敏性紫癜的临床效果及对T淋巴细胞亚群的影响。方法选取2020年1月至2021年7月杭州市儿童医院收治的83例过敏性紫癜患儿作为研究对象,根据随机数字表法将其分为研究组(41例)和单药组(42例)。单药组患儿采用孟鲁司特钠片治疗,研究组患儿采用孟鲁司特钠片加氯雷他定治疗。比较两组患儿的临床疗效、各项临床症状消失时间、不良反应发生情况及治疗前后T淋巴细胞亚群水平变化。结果研究组患儿的治疗总有效率显著高于单药组(P<0.05)。研究组患儿的关节疼痛、腹痛、血尿及皮肤紫癜消失时间均显著短于单药组(P<0.05)。两组患儿的过敏、恶心呕吐、皮肤损伤及血便发生率比较差异均无统计学意义(P>0.05)。研究组患儿治疗后的CD4^(+)T淋巴细胞、CD4^(+)/CD8^(+)均显著高于单药组,CD8^(+)T淋巴细胞显著低于单药组(P<0.05)。结论氯雷他定联合孟鲁司特钠片治疗过敏性紫癜的临床疗效显著,可促进临床症状消失,有助于改善T淋巴细胞亚群水平,且不增加不良反应发生风险,值得临床推广应用。

Objective To investigate the clinical effect of loratadine combined with montelukast sodium tablets in the treatment of Henoch-Schönlein purpura and its influence on T lymphocyte subsets.Methods Eighty-three children with Henoch-Schönlein purpura admitted to Hangzhou Children's Hospital from January 2020 to July 2021 were selected as the research objects,and they were divided into study group(41 cases)and single drug group(42 cases)according to random number table.Montelukast sodium tablets were used in single drug group and montelukast sodium tablets plus loratadine were used in study group.The clinical curative effect,the disappearance time of clinical symptoms,the occurrence of adverse reactions and the changes of T lymphocyte subsets before and after treatment were compared between the two groups.Results The overall effective rate of study group was higher than that of single drug group(P<0.05).The disappearance time of joint pain,abdominal pain,hematuria and skin purpura in study group were shorter than those in single drug group(P<0.05).There were no significant differences in incidence of allergy,nausea and vomiting,skin injury and bloody stool between the two groups(P>0.05).After treatment,CD4^(+)and CD4^(+)/CD8^(+)in study group were higher than those in single drug group,while CD8^(+) was lower than that in single drug group(P<0.05).Conclusion Loratadine combined with montelukast sodium tablets is effective in the treatment of Henoch-Schönlein purpura,which can promote the disappearance of clinical symptoms and improve the level of T lymphocyte subsets,and does not increase the risk of adverse reactions,so it is worthy of clinical application.