玉屏风联合糖皮质激素治疗过敏性紫癜的疗效观察以及对相关炎症因子表达的影响

Observation on the curative effect of Yupingfeng combined with glucocorticoid in the treat⁃ment of allergic purpura and its influence on the expression of related inflammatory factors

目的探讨玉屏风联合糖皮质激素治疗过敏性紫癜的临床疗效,以及对相关炎症因子表达的影响。方法将80例紫癜患儿均分成两组进行对照试验,对照组采用一般常规激素疗法,实验组在对照组基础上加用玉屏风,观察患者激素减量时间、使用总量、治愈率以及复发例数;治疗前及治疗后,检测两组患者外周血中IL⁃2、IL⁃4的表达水平,使用免疫组化技术检测GRα的表达,比较两组之间差异。结果实验组患者在激素使用量、治愈率及复发例数方面明显优于对照组,差异均具有统计学意义(P<0.05)。两组患者在接受治疗后对IL⁃2、IL⁃4进行比较,实验组其IL⁃2水平较对照组有明显升高,差异有统计学意义(P<0.05),而IL⁃4显著下降,差异有统计学意义(P<0.05);对两组患者治疗前后外周血单个核细胞中GRα的表达对比,对照组在接受治疗后GRα的表达明显降低,差异有统计学意义(P<0.05),而实验组无明显降低,差异有统计学意义(P>0.05),在接受治疗后对照组GRα的表达明显高于实验组,差异有统计学意义(P<0.05)。结论玉屏风联合糖皮质激素治疗过敏性紫癜疗效显著,可能与玉屏风具有免疫调节及提升单个核细胞中GRα的表达有关。

Objective To explore the efficacy of Yupingfeng combined with glucocorticoid(GC)in the treatment of Henoch⁃Schonlein purpura(HSP)and its effect on the expression of related inflammatory factors.Methods Eighty children with HSP were divided equally into two groups for control test,the control group was treated with GC,while the experimental group was given Yupingfeng therapy on the basis of the control group,the total amount of hormone reduction,cure rate and the number of recurrent cases were ob⁃served.Before and after treatment,the expression levels of IL⁃2,IL⁃4 in peripheral blood between the two groups were tested,and the expression of glucocorticoid receptor alpha(GRα)was tested by immunohisto⁃chemistry,the differences between the two groups were compared.Results The amount of hormone used,the cure rate and the number of recurrent cases in the experimental group were significantly better than those in the control group(P<0.05).After treatment,there was no significant change of IL⁃2 and IL⁃4 levels in the control group,while the expression of IL⁃2 increased significantly and IL⁃4 decreased significantly in the ex⁃perimental group(P<0.05),the difference between the two groups after treatment was statistically significant(P<0.05).There was no significant difference in the expression of GRαin peripheral blood mononuclear cells PBMC)between the two groups before treatment.After treatment,the expression of GRαin the control group decreased significantly,the difference between before and after treatment was statistically significant(P<0.05),while the decrease in the experimental group was not significant(P>0.05),after treatment,the expres⁃sion in the experimental group was significantly higher than that in the control group(P<0.05).Conclusion Yupingfeng combined with GC is effective in the treatment of HSP,which may be related to the immune regu⁃lation of Yupingfeng and the enhancement of the expression of GRαin peripheral blood mononuclear cells.