| Objective:Through real-world research methods,the clinical symptoms and TCM symptoms of children with Henoch-Sch(?)nlein purpura are collected for statistics and comparison,and the relevant examination results are collected to evaluate and analyze the effectiveness of the Six Classics characteristic organ differentiation scheme in the treatment of purpura,which provides a valuable therapeutic basis for the systematic evaluation of the Six Classics Organs Dialectic Scheme and lays a foundation for clinical promotion and application.Methods: This study selected a total of 1010 children with Henoch-Sch(?)nlein purpura from 5 hospitals from 2018 to 2022,and applied real-world research methods,according to the different clinical symptoms of patients,divided into five subtypes of skin type,abdominal type,joint type,renal type and mixed type,each subtype was divided into treatment group and control group,with a total of 505 cases of traditional Chinese medicine treatment group and 505 cases of Western medicine control group.Under the premise that there were no obvious differences in gender,age and course of the two groups of children,the Chinese medicine treatment group adopted the six characteristic organ dialectics according to the different conditions of the children,and those who met the evidence of Taiyin and Yang were added or subtracted with the diarrhea yellow powder;those who met the Shaoyin Fire Blazing Certificate were added or subtracted by the Jade Girl Heart Sutra Soup;those who met the Shaoyin Stasis Obstruction Certificate were added or subtracted by the enemy egg soup;those who met the Shaoyin False Fire Certificate were given the Acid Bai Di Huang Pill plus or minus;those who met the two deficiency certificates were given two days of cultivation of pulse soup plus or minus.The control group of Western medicine adopted: prednisolone acetate tablets,loratadine tablets,vitamin C tablets,captopril,dipyridamole tablets,calcium carbonate D3 granules orally.Among them,the drug is taken for 4 weeks for those with no renal lesions in the skin,abdominal,joint and mixed types,and 12 weeks for those with renal and mixed renal lesions.The specific dosage is based on the age and weight of the child.Subsequently,the clinical symptoms and TCM symptoms of each type of treatment were compared with each group before and after treatment,the relevant examination results were statistically counted,the effectiveness and safety of the six characteristic organs dialectical scheme in the treatment of this disease were systematically evaluated,and the recurrence of rashes,abdominal pain,joint pain,proteinuria and hematuria was followed up in March.Results:1.The clinical trial found that the majority of children with henoch schonlein Purpura were of han nationality(31.2%),followed by Tibetan nationality(27.0%)and Yi nationality(8.0%).The children of Han nationality are mainly concentrated in the plain area of Sichuan,while the children of Tibetan and Yi nationality live in mountainous areas and plateau.Most of the onset seasons were spring(30.6%)and winter(29.7%).Most of the onset cases were hidden,and most of the inducement cases were extrinsic.2.According to clinical symptoms,376 cases(37.2%)of skin type,140 cases(13.9%)of abdominal type,178 cases(17.6%)of articular type,130 cases(12.9%)of renal type,186 cases(18.4%)of mixed type were included.3.The results of clinical symptoms comparison were as follows :(1)after examination,there was no statistical significance in the main symptoms except the mixed type control group in hematuria and proteinuria(P>0.05);The self-comparison of the remaining types before and after treatment was obvious,indicating that both Chinese and Western medicine treatment can improve skin rash,abdominal pain,joint swelling and kidney damage.(2)In terms of secondary symptoms,in addition to the joint type,the treatment group and the control group of skin type and abdominal type had obvious effects on hematuria and proteinuria symptoms;In terms of improving halitosis,skin type,abdominal type,joint type and mixed type of control group had no effect,P>0.05;The effect of the four types of treatment group and renal type of treatment group and control group were obvious.In terms of improving upset,the symptoms of skin type,abdominal type and mixed type control group were not improved(P>0.05),and the treatment effect of the remaining subgroups was good.In the improvement of sweating,except for skin type,abdominal type and kidney type,there was no improvement(P>0.05),and the treatment effect of the remaining groups was good.In terms of improving hand,foot and heart heat,except for the joint type and abdominal type of the control group,there was no improvement in symptoms(P>0.05),the treatment effect of the other types of groups were good.In terms of improving constipation,the symptoms of skin type,abdominal type,closed type and mixed type control group were not improved(P>0.05),and the treatment effect of the remaining subgroups was good.However,the effect of the five component groups on improving abdominal distension,thirst and night restlessness was all good(P<0.01).4.Five types of treatment after the comparison between the results of statistics:(1)in terms of purpura rash,there was no difference between the treatment group and the control group except for the joint type(P>0.05),and the therapeutic effects of the remaining four types were better in the treatment group than the control group(P<0.05).(2)In the improvement of abdominal pain,there was no statistical significance in the abdominal type and mixed type of treatment group and control group,P>0.05,indicating that the effect was good.(3)In terms of improving arthralgia,the treatment group of the joint type was more effective than the control group(P<0.01).(4)In the improvement of hematuria,the effect of renal type and mixed type treatment group was better than the control group(P<0.05).The effect of renal type in improving proteinuria was better in the treatment group than in the control group(P<0.01).(5)In terms of improving arthralgia and proteinuria,there was no statistical significance in the mixed treatment group and the control group(P>0.05),indicating that both groups had better effects.(6)In the improvement of hematuria and proteinuria,there was no statistical significance in the treatment group and control group of skin type,abdominal type and joint type,indicating that the treatment effect of traditional Chinese medicine and western medicine was good(P>0.05).(7)In the improvement of TCM symptoms,the effect of the five types of treatment group was better than the control group(P<0.01).5.Comparison of efficacy evaluation: the healing rate of the five components of the treatment group was higher than the control group,but there was no difference in the total effective rate between the treatment group and the control group,indicating that both traditional Chinese medicine and western medicine are effective.6.In terms of adverse reactions,no adverse reactions were observed in the treatment group and control group of skin type,abdominal type and joint type,as well as in the treatment group of kidney type and mixed type.Renal type and mixed type control group all had hyperappetite,irritability,and weight gain of varying degrees(≥2kg).There were 5 cases of oral ulcer in renal type control group,3 cases of oral ulcer in mixed type and 3 cases of cold.7.Statistics of recurrence during follow-up: The recurrence rate of rash recurrence in all children was 13.5% in the treatment group and 46.7% in the control group,2.45% in the control group,8.4% in the treatment group and 22.4% in the control group,and 64.7% in the treatment group whose original urinary test abnormalities were still unrecovered.The control group was 94.7%.The overall cure rate was 71.7% in the Chinese medicine treatment group and 21.9% in the Western medicine control group,and the Chinese medicine treatment group was higher than that in the Western medicine control group.The main causes of recurrence were exogenous feeling,unrestricted diet and uncontrolled exercise.Overall,the recurrence rate of rash and kidney involvement in the Chinese medicine group were lower than those in the western medicine group.It suggests that all kinds of symptoms of purpura are easy to repeat in the first three months of the occurrence of the disease,and the persistence and repetition of symptoms may be associated with kidney damage.Conclusion:The six channels syndrome differentiation scheme has definite curative effect in the treatment of Henoch-sch(?)nlein purpura.It has remarkable effect in improving rash,abdominal pain,arthralgia and kidney damage,and has outstanding effect in improving various TCM symptoms,and can effectively reduce the recurrence of the disease and prevent kidney damage,with few side effects,so it is worth promoting the use of the same syndrome differentiation in the disease.The tutor’s experience in the treatment of hematuria and proteinuria with unknown etiology is also worth learning. |
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