中西医结合治疗对儿童过敏性紫癜肾损害的预防作用

目的观察中西医结合治疗儿童过敏性紫癜(HSP)的临床疗效及对肾损害的预防作用。方法将120例患儿随机分为2组。对照组60例,采用西医常规治疗;中西医结合治疗组60例,在对照组基础上应用三黄清血饮治疗。同时选择30名健康儿童作为健康组。观察治疗前后症状、体征,尿常规,血浆内皮素-1(ET-1)、尿β2-微球蛋白(β2-MG)、尿白蛋白(Alb)、尿免疫球蛋白G(IgG)变化及治疗后的复发情况。结果治疗组治愈率、总有效率分别为80.0%(48/60)、98.3%(59/60);对照组分别为61.7%(37/60)、88.3%(53/60),两组比较差异有统计学意义(P<0.05);治疗组治愈患儿临床症状消失时间短于对照组,差异有统计学意义(P<0.01);治疗组治疗1个月后血浆ET-1、尿β2-MG、尿Alb、尿IgG指标明显改善,均低于本组治疗前及对照组同期水平,差异有统计学意义(P<0.01,P<0.05),与健康组比较,差异无统计学意义(P>0.05)。治疗组1年复发率为13.3%,对照组为30.0%,两组比较差异有统计学意义(P<0.05)。结论中西医结合治疗儿童HSP不仅明显减轻临床症状,缩短病程,降低复发率,而且能够有效地预防儿童HSP肾损害。

英文摘要:

Objective To observe the clinical effect of integrative medicinal therapy in treating children Henoch-Schonlein purpura(HSP) and its preventive effect on complicated renal impairment.Methods One hundred and twenty children with HSP were equally randomized into two groups,the treated group and the control group.Both were treated with conventional Western medical therapy,but Sanhuang Qingxue Yin(SQY,a Chinese herbal drug) was given additionally to the treated group.Besides,a group consisted of 30 healthy children was set up as a normal control.Changes of symptoms,physical signs,routine urine,plasma endothelin-1(ET-1) and urinary levels of β2-microglobulin(β2-MG),albumin(ALB) and immunoglobulin G(IgG) before and after treatment were observed,and the recurrence was monitored.Results The cure rate and the total effective rate in the treated group were 80.0% and 98.3%,while those in the control group were 61.7% and 88.3%,showing significant differences between groups(P<0.05);the disappearance time of clinical symptoms was shorter in the treated group than in the control group,also showing a significant difference(P<0.01);after 1-month treatment,levels of plasma ET-1,and urinary β2-MG,ALB and IgG were improved in the treated group,reaching the levels opproximate to those in the normal control(P>0.05),significant difference was shown as compared with those in the control group and with those before treatment respectively(P<0.01,P<0.05).The recurrent rate was 13.33% in the treated group and 30.0% in the control group,and they were statistically different(P<0.05).Conclusion The integrative medicinal therapy is good for treating HSP in children,it could not only obviously relieve clinical symptoms,shorten the illness course and reduce the recurrent rate,but also effectively prevent the occurrence of renal impairment.

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