中药对儿童过敏性紫癜肾炎早期干预的影响

作者	单位
甄小芳	首都医科大学附属北京儿童医院
王子威	首都医科大学附属北京友谊医院儿科
卢燕	首都医科大学附属北京儿童医院

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中文摘要:

目的观察化瘀止血、凉血止血中药对过敏性紫癜肾炎(Henoch-Schonlein purpura nephritis,HSPN)发病率的影响。方法将证属出血兼血瘀证及出血兼血热证,且尿常规检查正常的141例患儿,按不同中医证型分为活血化瘀组和凉血止血组,两组分别采用化瘀止血中药及凉血止血中药治疗8周。观察肾脏损害发生率、发生时间,以及治疗前后生长转化因子(transforming growth factor,TGF)、D-二聚体(D-dimer,D-D)、免疫球蛋白系列(immunoglobulin,Ig)、尿微量蛋白及尿酶的变化。结果活血化瘀组肾脏损害发生率为36.2%,明显低于凉血止血组69.4%,肾脏损害出现时间(32.2±10.6)天,晚于凉血止血组(20.0±9.0)天,差异有统计学意义(P<0.05),活血化瘀组患儿治疗后TGF、D-D、IgA及尿微球蛋白(microglobulin,MG)、免疫球蛋白G(immunoglobulin G,IgG)、白蛋白(albuminuria,ALB)水平均低于治疗前及凉血止血组,差异均有统计学意义(P<0.05)。结论应用活血化瘀方法,可以减少过敏性紫癜(Henoch-Schonlein purpura,HSP)发生肾脏损害的机率,具有预防HSPN发生的作用。

英文摘要:

Objective To observe the effect of blood activating and cooling,stasis removing herbs on the occurrence rate of Henoch-Schonlein purpura nephritis(HSPN).Methods The 141 HSP children patients with bleeding of the blood stasis syndrome and of the blood heat syndrome(having normal results of urine routines) were assigned to the blood activating and stasis removing group and the blood cooling and arresting group.They were treated with blood activating and stasis removing herbs and blood cooling and arresting herbs respectively for eight weeks.The occurrence rate and time of the renal injury,changes of transforming growth factor(TGF),D-dimer(D-D),immunoglobulin(Ig),urine micro-protein,and urease before and after treatment were observed.Results The occurrence of the renal injury in the blood activating and stasis removing group was 36.2%,obviously lower than that in the blood cooling and arresting group(69.4%).The occurrence time of the renal injury was 32.2±10.6 days,obviously later than that in the blood cooling and arresting group(20.0±9.0 days),showing statistical difference(P<0.05).The levels of TGF,D-D,IgA,microglobulin(MG),immunoglobulin G(IgG),albuminuria(ALB) of children patients in the blood activating and stasis removing group were lower after treatment than before treatment,showing significant difference(P<0.05).Significant difference was also shown when compared with those of the blood cooling and arresting group(P<0.05).Conclusion The application of activating blood and removing stasis method could lower the probability of the renal injury in Henoch-Schonlein purpura(HSP).It played a role in preventing the occurrence of HSPN.

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