中西医结合治疗腹型过敏性紫癜湿毒内蕴患儿临床研究

Clinical study of integrated Chinese-Western therapy in treatment of children with damp toxin type of abdominal Henoch-Schonlein purpura

目的观察中西医结合治疗腹型过敏性紫癜(HSP)湿毒内蕴型患儿临床疗效。方法将70例腹型HSP湿毒内蕴型患儿随机分为对照组与治疗组各35例。对照组采用西医常规治疗方案,治疗组在对照组的治疗基础上加用解毒消痈止痛方。治疗前后对两组进行症状体征评分,通过检测外周血Th17/Treg细胞浓度,评估对免疫功能的调节;通过检测血浆二胺氧化酶(DAO)、D-乳酸和内毒素水平,评估肠黏膜屏障功能;统计两组不良事件。结果治疗后,两组总有效率差异无统计学意义(P>0.05),治疗组总显效率明显高于对照组(P<0.05);治疗1周和2周,两组症状评分均明显低于治疗前,治疗组治疗2周的症状体征评分明显低于对照组(P<0.05);两组外周血Treg细胞浓度、Treg/Th17比值明显高于治疗前,Th17细胞浓度均明显低于治疗前(P<0.05),治疗组Th17细胞浓度明显低于对照组,Treg/Th17比值均明显高于对照组(P<0.05),两组外周血Treg细胞浓度差异无统计学意义(P>0.05);两组血浆DAO、内毒素、D-乳酸水平均明显低于治疗前(P<0.05),但两组血浆DAO、内毒素、D-乳酸水平差异无统计学意义(P>0.05);两组均未出现任何不良事件。结论中西医结合治疗腹型HSP湿毒内蕴型患儿,显著提高总显效率,改善症状体征,调节免疫功能,安全性高,但在改善肠黏膜屏障功能方面作用不明显。

Objective To observe the efficacy of integrated Chinese-Western therapy in treatment of children with damp toxin type of abdominal Henoch-Schonlein purpura(HSP).Methods A total of 70 children with damp toxin type of HSP were randomly divided into control group and treatment group with 35 cases each.Control group was treated with methylprednisolone,and treatment group was treated with Jiedu Xiaoyong Zhitong Prescription on the basis of control group.Both groups were evaluated by scoring symptoms and signs before and after treatment;the regulation of immune function was assessed by measuring the concentration of Th17/Treg cells in peripheral blood;the intestinal mucosal barrier function was evaluated by measuring the levels of plasma diamine oxidase(DAO),D-lactate and endotoxin;the adverse events of the two groups were counted.Results After treatment,there was no significant difference in the total effective rate between the two groups(P>0.05),the total apparent efficiency rate of treatment group was significantly higher than that of control group(P<0.05);the symptom scores of both groups were significantly lower than those before treatment after 1 and 2 weeks of treatment,and were significantly lower in treatment group than control group(P<0.05);after 2 weeks of treatment,the concentration of Treg cells and Treg/Th17 ratio in the peripheral blood of both groups were significantly higher than that before treatment,and were significantly lower than before treatment(P<0.05),and the above indexes were superior in treatment group to those in control group(P<0.05);there was no significant difference in the concentration of Treg cells in peripheral blood between the two groups(P>0.05);the plasma DAO,endotoxin and D-lactate levels in both groups were significantly lower than those before treatment(P<0.05),but there was no significant difference between the two groups(P>0.05).Conclusion Integrated Chinese-Western therapy can significantly improve the total apparent efficiency,improve symptoms and signs,and regulate immune function in treatment of children with damp toxin type of abdominal HSP with high safety,but it has no obvious effect in improving the intestinal mucosal barrier function.