紫癜1号方治疗儿童过敏性紫癜性肾炎临床观察

Clinical Observation on the Treatment of Henoch-Schonlein Purpura Nephritis in Children by Purpura No.1

目的:观察紫癜1号方对紫癜性肾炎(HSPN)患儿外周血嗜酸性粒细胞及其凋亡因子Fas蛋白表达的影响。方法:选取2019年10月1日—2020年12月30日于深圳市中医院门诊和住院部诊治的HSPN患儿60例,随机分为观察组和对照组,各30例。观察组予紫癜1号方加减及中药针剂治疗,对照组给予西医常规治疗,2组疗程均为12周。观察治疗前、治疗第0、4、8、12周各时间段的尿N-乙酰氨基葡萄糖苷酶(NAG)、尿微量白蛋白(mALB)、β2-微球蛋白(β2-MG),以及血嗜酸性粒细胞(EOS)、死亡诱导因子(Fas)等变化情况和疗效变化。结果:治疗第4、8周时,观察组总有效率分别为83.33%、96.67%,明显高于对照组,组间比较有显著性差异(P<0.05);第4、8周时,观察组降低患儿NAG的效果显著优于对照组(P<0.01);各个观察时点观察组降低β2-MG的效果均优于对照组(P<0.05);第4、12周时,观察组降低m ALB的效果优于对照组(P<0.05)。治疗第4周时,促进Fas抗原表达、降低EOS的效果对照组优于观察组,差异有统计学意义(P<0.01)。结论:紫癜1号方在早期能改善HSPN患儿临床症状,对改善早期肾损害指标起效更快,作用更持久。

Objective:To observe the effect of Purpura No.1 Prescription on the expression of eosinophils and Fas protein in peripheral blood of children with Henoch-Schonein Purpura Nephritis(HSPN).Methods:Children with HSPN who visited the outpatient and/or inpatient department of Shenzhen Traditional Chinese Medicine Hospital from October 1st,2019 to December 30th,2020 were randomly divided into observation group(n=30)and control group(n=30).The observation group was treated with Purpura kidney No.1 prescription and traditional Chinese medicine injection,while the control group was treated with common western medicine.The treatment course of both groups was 12 weeks.The changes of urine N-acetylglucosaminidase(NAG),urine microalbumin(mALB),β2-microglobulin(β2-MG),blood eosinophile granulocyte(EOS)and factor asscioated suicide(Fas)and the changes of curative effect were observed before treatment,at the 0th,4th,8th and 12th weeks of treatment.Results:The effective rate of Henoch-Schonlein Purpura No.1 prescription at the 4th and 8th weeks were 83.33%and 96.67%,which was higher than that of the control group(P<0.05).At the 4th and 8th weeks,the observation group was superior to the control group in reducing NAG,and the difference was statistically significant(P<0.01).The reduction ofβ2-MG in the treatment group was better than that in the control group at each observation time point,and the difference was statistically significant(P<0.05).At the 4th and 12th week,the decrease of mALB in the observation group was better than that in the control group,and the difference was statistically significant(P<0.05).At the 4th week,the control group was superior to the treatment group in promoting Fas antigen expression and reducing EOS,and the difference was statistically significant(P<0.01).Conclusion:Henoch-Schonlein Purpura No.1 prescription can improve the clinical symptoms of children with HSPN in the early stage,and has a faster and more lasting effect on improving early renal damage indexes.