白芍总苷胶囊联合孟鲁司特钠治疗小儿过敏性紫癜的临床研究

Clinical study on Total Glucosides of White Paeony Capsules combined with montelukast sodium in treatment of allergic purpura in children

目的探讨白芍总苷胶囊联合孟鲁司特钠咀嚼片治疗小儿过敏性紫癜的临床疗效。方法选取2015年10月—2017年1月河南科技大学第一附属医院收治的小儿过敏性紫癜患儿94例为研究对象,根据随机区组设计法将患者分为对照组和治疗组,每组各47例。对照组口服孟鲁司特钠咀嚼片,体质量<30 kg,4 mg/次,体质量≥30 kg,8 mg/次,1次/d。治疗组在对照组治疗的基础上口服白芍总苷胶囊,体质量<30 kg,3 mg/次,体质量≥30 kg,6 mg/次,3次/d。两组患儿均连续治疗1个月。观察两组的临床疗效,比较两组的临床症状消失时间、血清抗体水平、血清炎性因子、复发率。结果治疗后,对照组和治疗组的总有效率分别为76.6%、95.7%,两组比较差异有统计学意义(P<0.05)。治疗后,治疗组皮肤紫癜、胃肠病变、关节红肿消失时间均显著短于对照组,两组比较差异具有统计学意义(P<0.05)。治疗后,两组血清IgA水平明显降低,IgM、IgG水平均明显升高,同组治疗前后比较差异有统计学意义(P<0.05);且治疗组血清抗体水平明显优于对照组,两组比较差异具有统计学意义(P<0.05)。治疗后,两组血清白细胞介素-4(IL-4)、白细胞介素-6(IL-6)、白细胞介素-8(IL-8)水平均显著降低,同组治疗前后比较差异有统计学意义(P<0.05);且治疗组血清炎性因子水平明显低于对照组,两组比较差异具有统计学意义(P<0.05)。治疗后,对照组、治疗组6个月复发率分别为17.0%、2.1%,12个月复发率分别为25.5%、6.4%,两组复发率比较差异有统计学意义(P<0.05)。结论白芍总苷胶囊联合孟鲁司特钠咀嚼片治疗小儿过敏性紫癜临床疗效显著,可减轻患者的临床症状,调节免疫功能和炎性因子水平,降低复发率,具有一定的临床推广应用价值。

Objective To investigate the effect of Total Glucosides of White Paeony Capsules combined with Montelukast Sodium Chewable Tablets in treatment of allergic purpura in children. Methods Children(94 cases) with allergic purpura in the First Affiliated Hospital of Henan University of Science and Technology from October 2015 to January 2017 were randomly divided into control and treatment groups, and each group had 47 cases. Patients in the control group were po administered with Montelukast Sodium Chewable Tablets, body weight < 30 kg, 4 mg/time, body weight≥ 30 kg, 8 mg/time, once daily. Patients in the treatment group were po administered with Total Glucosides of White Paeony Capsules on the basis of the control group, body weight < 30 kg, 3 mg/time, body weight ≥ 30 kg, 6 mg/time, three times daily. Patients in two groups were treated for 1 month. After treatment, the clinical efficacies were evaluated, and the disappearance time of clinical symptoms, serum antibody level, serum inflammatory factors, and recurrence rate in two groups were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 76.6% and 95.7%, respectively, and there was difference between two groups(P < 0.05). After treatment, the disappearance times of skin purpura, gastrointestinal lesions, and joint swelling in the treatment group were shorter than those in the control group, and there was difference between two groups(P < 0.05). After treatment, the levels of IgA in two groups were significantly decreased, but the levels of IgM and Ig G in two groups were significantly increased, and the difference was statistically significant in the same group(P < 0.05). And the observational indexes in the treatment group were significantly better than those in the control group, with significant difference between two groups(P < 0.05). After treatment, the levels of IL-4, IL-6, and IL-8 in two groups were significantly decreased, and the difference was statistically significant in the same group(P < 0.05). And the serum inflammatory factors indexes in the treatment group were significantly lower than those in the control group, with significant difference between two groups(P < 0.05). After treatment, the recurrence rates after 6 months in the control and treatment groups were 17.0% and 2.1%, respectively, and the recurrence rates after 12 months in the control and treatment groups were 25.5% and 6.4%, respectively, and there was difference between two groups(P < 0.05). Conclusion Total Glucosides of White Paeony Capsules combined with Montelukast Sodium Chewable Tablets has clinical curative effect in treatment of allergic purpura in children, can alleviate the clinical symptoms, regulate the immune function and the level of inflammatory factors, and reduce the recurrence rate, which has a certain clinical application value.