| Anaphylactoid purpura is a kind of general vasculitis which is originated by many causes,refer to many system such as skin, gastrointestinal tract,joints,kidneys and so on.It is more common between 3 and 10 years old,and boys are more than girs,the ratio is about 1.4:1. This disease is common,it can be found in the whole year, but winter and sping is more common. The renal's injure whose occurance rate is high makes parents and physician pay attention to.In addition to that, the other character is recurrent attacks easily, even in the treatment period.It makes the disease and the injure more serious.So to explore the pathogenesis and search the good and effective treatment methods is very important. In recent years, the research of this disease concentrates on the immunology and to illuminate the immunological pathogenesis.Glystrrhizin is a kind of effective active component which is made from the root and stem of Glycyrrhiza, which is high saccharinity, low calorie, safety and atoxic. Its effects include anti-inflammatory, anti-virus, anti-allergy and immunological regulation. In recent years, with the GL's drug value be developed, it has be used in many clinical diseases such as protecting liver, the therapeutic effect is very good. Now the therapeutic effect in those non-liver diseases is focal point in present researches.Objective1,To explore the immunological pathogenesis of HSP; To observe the states of balance between Th1/Th2 and the function of T cells in children with HSP in the acute phase.2,Clinical effect and immunological regulatory mechanism of glycyrrhizin in the treatment of childhood anaphylactoid purpura.MethodsSixty children with HSP who are pathogenetic first time all have the typical hemorrhagic rash and the other symptoms (52cases with abdominal pain, 13 cases with joints sweeling and pain, 32cases with urine routine change) all of patients were randomly divided into three groups according to treatment drugs: the regular treatment group, glycyrrhizin group, dexamethasone group, every group include 20 cases. All cases are given the basic treatment such as controlling infection, anti-allergy, improving capillary fragility, anti-histamine and so on. Control were cured with routine treatment method only, glycyrrhizin group were added glycyrrhizin to the cure procedure, beside routine cure method,Patients of the three teams were drawn blood both before and after therapy. Serum was collected and kept in low temperature to be detected. CD3,CD4 was performed by flow cytometry, cytokines IL-13,IL-18,IL-4,INF-γwere determined by ELISA. observing remission rate of abdominal symptom joints sweeling and urine routine change and other symptoms, detecting the patients'T lymphocyte subsets, and analysis the changes INF-γ,IL-4,IL-13,IL-18 before and after therapy. All data will be analyzed withSPSS statistic software.Results1,By the comparison with each group clinical effect, it show that as follows:Firstly it had statistically significant differences among 3 groups (P<0.05). Secondly effective rate of glycyrrhizin group is higher than regular treatment group, lower than dexamethasone group,it had statistically significant differences (P<0.05).2,By the comparison with each group IL-4, it show that as follows:Firstly it had not statistically significant differences among 3 groups (P<0.05). By the comparison with each group IL-4 the change between before and after treatment,the one of glycyrrhizin group is bigger than regular treatment group, it had statistically significant differences (P<0.01) but compare to the dexamethasone group, it had not statistically significant differences (P>0.05).3,By the comparison with each group INF-γ, it show that as follows:Firstly it had not statistically significant differences among 3 groups before treatment (P<0.05). By the comparison with each group INF-γthe change between before and after treatment, the one of glycyrrhizin group is bigger than regular treatment group, it had statistically significant differences (P<0.01) but compare to the dexamethasone group, it had not statistically significant differences (P>0.05).4,By the comparison with each group IL-13, it show that as follows:Firstly it had not statistically significant differences among 3groups before treatment (P>0.05). By the comparison with each group IL-13 the change between before and after treatment, the one of glycyrrhizin group is bigger than regular treatment group and the dexamethasone group, it had statistically significant differences (P<0.01).5,By the comparison with each group IL-18, it show that as follows:Firstly it had not statistically significant differences among 3 groups before treatment (P>0.05). By the comparison with each group IL-18 the change between before and after treatment, the one of glycyrrhizin group is bigger than regular treatment group and the dexamethasone group, it had statistically significant differences (P<0.01).6,Comparing T lymphocyte subsets between HSP group and control group, CD3 decreased, CD4and CD4/CD8 increased, it had statistically significant differences, CD8 decreased a little, but it had no significant differences. comparing the non-renal injure group, CD8 in renal injure group decreased, the differences is significant.Conclusion1,IL-4 increased in the acute phase in the children of HSP, INF-γdecreased,there is Th1/Th2 deviation.2,IL-13 increased and IL-18 had no change in the acute phase in the children of HSP.3,Glycyrrhizin can step up the level of INF-γand degrade the IL-4, to regulate Th1/Th2 deviation.4,Glycyrrhizin can degrade the IL-13 and step up the level of INF-γ, to regulate Th1/Th2 deviation indirectly.5,CD3 decreased, CD4 and CD4/CD8 increased, CD8 in renal injure group decreased in the acute phase of HSP. |
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