Henoch-Schnlein purpura(HSP) is a small-vessel vasculitis mediated by IgA-immune complex deposition.It is characterized by the clinical tetrad of non-thrombocytopenic palpable purpura,abdominal pain,arthritis and rena...Henoch-Schnlein purpura(HSP) is a small-vessel vasculitis mediated by IgA-immune complex deposition.It is characterized by the clinical tetrad of non-thrombocytopenic palpable purpura,abdominal pain,arthritis and renal involvement.The diagnosis of HSP is difficult,especially when abdominal symptoms precede cutaneous lesions.We report a rare case of paroxysmal drastic abdominal pain with gastrointestinal bleeding presented in HSP.The diagnosis was verified by renal damage and the occurrence of purpura.展开更多
Henoch-Schonlein purpura （HSP） is an IgA-mediated vasculitis which is easy to relapse. A lot of patients have to useglucocorticoids, immunosuppressive drugs and other drugs which will bring sorts of serious side eff...Henoch-Schonlein purpura （HSP） is an IgA-mediated vasculitis which is easy to relapse. A lot of patients have to useglucocorticoids, immunosuppressive drugs and other drugs which will bring sorts of serious side effects. Unfortunately,most of patients have to face the hurt of abdominal pain, arthritis, purpuric rash and renal involvement again after relapse.We have used Xiaochaihu decoration which is a famous formula in Shanghanlun to cure most of patients, especially whowith abdominal pain and purpuric rash. Due to the fact that this formula belongs to the Shaoyang Channels, interestingly,we find that these symptoms are located in regions close to the Shaoyang Channels. So that is the reason why Xiaochaihu decoration could work.展开更多
Objective： The treatment of Henoch-Schonlein purpura （HSP） with moderate proteinuria remains con- troversial. We retrospectively analyzed the efficacy of immune suppressants, with a particular emphasis on myco- phe...Objective： The treatment of Henoch-Schonlein purpura （HSP） with moderate proteinuria remains con- troversial. We retrospectively analyzed the efficacy of immune suppressants, with a particular emphasis on myco- phenolate mofetil （MMF）. Methods： Ninety-five HSP patients with moderate proteinuria （1.0-3.5 g/24 h） after at least three months of therapy with angiotensin-converting enzyme inhibitor （ACEI） or angiotensin receptor blocker （ARB） were divided into three groups： an MMF group （n=33） that received MMF 1.0-1.5 g/d combined with prednisone （0.4-0.5 mg/（kg.d））, a corticosteroid （CS） group （n=31） that received full-dose prednisone （0.8-1.0 mg/（kg.d））, and a control group （n=31）. Patients in the MMF and CS groups continued to take ACEI or ARB at the original dose. The patients in the control group continued to take ACEI or ARB but the dose was increased by （1.73±0.58）-fold. The patients were followed up for 6-78 months （median 28 months）. Results： The baseline proteinuria was higher in the MMF group （（2.1±0.9） g/24 h） than in the control group （（1.6±0.8） g/24 h） （P=0.039）. The proteinuria decreased sig- nificantly in all groups during follow-up, but only in the MMF group did it decrease significantly after the first month. At the end of follow-up, the proteinuria was （0.4±0.7） g/24 h in the MMF group and （0.4±0.4） g/24 h in the CS group, significantly lower than that in the control group （（0.9±1.1） g/24 h）. The remission rates in the MMF group, CS group, and control group were respectively 72.7%, 71.0%, and 48.4% at six months and 72.7%, 64.5%, and 45.2% at the end of follow-up. The overall number of reported adverse events was 17 in the MMF group, 30 in the CS group, and 6 in the control group （P〈0.001）. Conclusions： MMF with low-dose prednisone may be as effective as full-dose prednisone and tend to have fewer adverse events. Therefore, it is probably superior to conservative treatments of adult HSP patients with moderate proteinuria.展开更多
OBJECTIVE:To research the curative effect of Chinese herbs for clearing away heat,promoting diuresis,nourishing the kidney,and consolidating essence in children with Henoch-Schonlein purpura nephritis(HSPN)with intern...OBJECTIVE:To research the curative effect of Chinese herbs for clearing away heat,promoting diuresis,nourishing the kidney,and consolidating essence in children with Henoch-Schonlein purpura nephritis(HSPN)with internal accumulation of damp-toxin using randomized controlled observations on large samples.To seek the mechanism of the therapy and its scope of indications.METHODS:Overall,186 children with HSPN were randomly divided into two groups:treatment group(n=126)treated with Chinese herbs for clearing heat and promoting diuresis and a control group(n=60)treated with Western Medicine.The treatment was carried out for three courses of 4weeks each.We recorded changes in patient urine routines,24 h urinary protein,blood-coagulating series,immunoglobulin and T-cell subgroups,and improvements in main symptoms.We evaluated the alleviation of clinical symptoms and the improvement of proteinuria,hematuria,and other lab-oratory test results.Finally,we analyzed the patient population suitable for this therapy according to the relationship between the grouping of patient body weight and curative effect.RESULTS:Damp-heat syndrome improved in the treatment group,with a significant difference in total effective rate after a 4-week treatment(χ2=13.5220,P=0.0002)and in curative rate after a12-week treatment(χ2=6.3410,P=0.0118),compared to those in the control group.The curative effect in the treatment group was greater than that in the control group but there was no statistical difference between the two groups.The curative effect after a 4-week treatment of patients in the treatment group weighing 30 kg or less based on Traditional Chinese Medicine(TCM)signs and urinary protein was significantly greater than that in the control group.However,there was no statistical difference in the curative effect on urinary red cells and various indexes after a 12-week treatment between the two groups.CONCLUSION:Therapy for clearing away heat,promoting diuresis,nourishing the kidney,and consolidating essence using TCM is effective in children with HSPN from internal accumulation of damp-toxin.The therapy is especially suitable for patients weighing 30 kg or less.The curative effect may be related to the improvement of immune function and blood-coagulation.展开更多
基金Supported by The Major Projects Incubator Program of Sun Yat-Sen University,No.10ykjc25One Hundred Talents Program of Sun Yat-Sen University,No.82000-3171310+1 种基金Guangdong Science and Technology Program,No.2009B060300001National Natural Science Foundation of China,No.30971357
文摘Henoch-Schnlein purpura(HSP) is a small-vessel vasculitis mediated by IgA-immune complex deposition.It is characterized by the clinical tetrad of non-thrombocytopenic palpable purpura,abdominal pain,arthritis and renal involvement.The diagnosis of HSP is difficult,especially when abdominal symptoms precede cutaneous lesions.We report a rare case of paroxysmal drastic abdominal pain with gastrointestinal bleeding presented in HSP.The diagnosis was verified by renal damage and the occurrence of purpura.
基金This study was supported by the National Natural Science Foundation of China （No. 81202839）, the NationalNatural Science Foundation of China （No. 81774080）, the Natural Science Foundation of Shandong Province（ZR2012HQ023）,the Medical science and technology development Foundation of Shandong Province, China （No.2014WS0431）, the Jinan young star of science and technology plan （No. 201406012）, and the Affiliated Hospital ofShandong University of Traditional Chinese Medicine and Shandong University, China.
文摘Henoch-Schonlein purpura （HSP） is an IgA-mediated vasculitis which is easy to relapse. A lot of patients have to useglucocorticoids, immunosuppressive drugs and other drugs which will bring sorts of serious side effects. Unfortunately,most of patients have to face the hurt of abdominal pain, arthritis, purpuric rash and renal involvement again after relapse.We have used Xiaochaihu decoration which is a famous formula in Shanghanlun to cure most of patients, especially whowith abdominal pain and purpuric rash. Due to the fact that this formula belongs to the Shaoyang Channels, interestingly,we find that these symptoms are located in regions close to the Shaoyang Channels. So that is the reason why Xiaochaihu decoration could work.
基金supported by the National Key Technology R&D Program of China(No.2013BAI09B04)the Medical Research Funds from the Bureau of Health of Zhejiang Province(No.2013KYA072),China
文摘Objective： The treatment of Henoch-Schonlein purpura （HSP） with moderate proteinuria remains con- troversial. We retrospectively analyzed the efficacy of immune suppressants, with a particular emphasis on myco- phenolate mofetil （MMF）. Methods： Ninety-five HSP patients with moderate proteinuria （1.0-3.5 g/24 h） after at least three months of therapy with angiotensin-converting enzyme inhibitor （ACEI） or angiotensin receptor blocker （ARB） were divided into three groups： an MMF group （n=33） that received MMF 1.0-1.5 g/d combined with prednisone （0.4-0.5 mg/（kg.d））, a corticosteroid （CS） group （n=31） that received full-dose prednisone （0.8-1.0 mg/（kg.d））, and a control group （n=31）. Patients in the MMF and CS groups continued to take ACEI or ARB at the original dose. The patients in the control group continued to take ACEI or ARB but the dose was increased by （1.73±0.58）-fold. The patients were followed up for 6-78 months （median 28 months）. Results： The baseline proteinuria was higher in the MMF group （（2.1±0.9） g/24 h） than in the control group （（1.6±0.8） g/24 h） （P=0.039）. The proteinuria decreased sig- nificantly in all groups during follow-up, but only in the MMF group did it decrease significantly after the first month. At the end of follow-up, the proteinuria was （0.4±0.7） g/24 h in the MMF group and （0.4±0.4） g/24 h in the CS group, significantly lower than that in the control group （（0.9±1.1） g/24 h）. The remission rates in the MMF group, CS group, and control group were respectively 72.7%, 71.0%, and 48.4% at six months and 72.7%, 64.5%, and 45.2% at the end of follow-up. The overall number of reported adverse events was 17 in the MMF group, 30 in the CS group, and 6 in the control group （P〈0.001）. Conclusions： MMF with low-dose prednisone may be as effective as full-dose prednisone and tend to have fewer adverse events. Therefore, it is probably superior to conservative treatments of adult HSP patients with moderate proteinuria.
基金Supported by the Special Traditional Chinese Medicine Research Project of State Traditional Chinese Medicine Administration(No.200807017)
文摘OBJECTIVE:To research the curative effect of Chinese herbs for clearing away heat,promoting diuresis,nourishing the kidney,and consolidating essence in children with Henoch-Schonlein purpura nephritis(HSPN)with internal accumulation of damp-toxin using randomized controlled observations on large samples.To seek the mechanism of the therapy and its scope of indications.METHODS:Overall,186 children with HSPN were randomly divided into two groups:treatment group(n=126)treated with Chinese herbs for clearing heat and promoting diuresis and a control group(n=60)treated with Western Medicine.The treatment was carried out for three courses of 4weeks each.We recorded changes in patient urine routines,24 h urinary protein,blood-coagulating series,immunoglobulin and T-cell subgroups,and improvements in main symptoms.We evaluated the alleviation of clinical symptoms and the improvement of proteinuria,hematuria,and other lab-oratory test results.Finally,we analyzed the patient population suitable for this therapy according to the relationship between the grouping of patient body weight and curative effect.RESULTS:Damp-heat syndrome improved in the treatment group,with a significant difference in total effective rate after a 4-week treatment(χ2=13.5220,P=0.0002)and in curative rate after a12-week treatment(χ2=6.3410,P=0.0118),compared to those in the control group.The curative effect in the treatment group was greater than that in the control group but there was no statistical difference between the two groups.The curative effect after a 4-week treatment of patients in the treatment group weighing 30 kg or less based on Traditional Chinese Medicine(TCM)signs and urinary protein was significantly greater than that in the control group.However,there was no statistical difference in the curative effect on urinary red cells and various indexes after a 12-week treatment between the two groups.CONCLUSION:Therapy for clearing away heat,promoting diuresis,nourishing the kidney,and consolidating essence using TCM is effective in children with HSPN from internal accumulation of damp-toxin.The therapy is especially suitable for patients weighing 30 kg or less.The curative effect may be related to the improvement of immune function and blood-coagulation.
