| Objectives:1. To know the situation of purpura nephritis in Chinese medicine and Modern medical research through clinical literature review.2. To evaluate the Chinese medicine's advantages for children purpura nephritis by clinical retrospective study.3. To explore the evaluation method of Chinese medical treatment for the purpura nephritis, as the basis for the clinical treatment for better promoting the modernization of Chinese medicine by comparing the different efficacy evaluation method.Methods:1. Literature research:After checking the ancient and modern, domestic and foreign on children's literature purpura nephritis, we study and summarize Chinese and Western research situation.2. Clinical research:Search 2002～2009 purpura nephritis in children's medical records in Jiangsu Province Chinese Medicine Hospital and Nanjing General Hospital of Nanjing Military Command, under the retrospective clinical research methods, according to their medication, it could be divided into treatment group in the way of integration of traditional and western medicine and western medicine group. Through collection of related symptoms, signs, clinical examination and treatment of various conditions, in SPSS 17.0, using principal component analysis, cluster analysis, t test, chi-square test, rank sum test and other statistical methods, from the contrast between groups in before and after treatment, comparing different treatments efficacy, side effects and other differences.3.Comparing the conformity assessment results of different effects, we explore the evaluation system of Chinese medicine for treatment of children with Henoch-Schonlein Purpura Nephritis.Results:1. Literature:①Purpura nephritis disease does not directly correspond to the traditional Chinese medical name. Chinese medicine attributed to "xuezheng", "faban", "ziban", "grape epidemic", "jinv," " hematuria," "edema" category according to the clinical manifestations of this disease. The occurrence of this disease related to heat-toxicity, heat-toxicity intrinsic, meridians obstructed, became macula. heat injure meridians, blood circulation abnormal, there hematuria. After long course, blood stasis in renal collaterals lend to nutrition leaked out.Wind, heat, poison, blood stasis, weakness is the main pathogenesis. Chinese medicine on the treatment HSPN of children achieved good effect, summarized in the differentiation into stages, syndrome differentiation, special methods in special medication and single herb preparation.②Understanding of modern medicine:purpura nephritis is extensive necrotizing vasculitis as the basic disease, associated with IgA immune complex deposition in the vessel wall, glomerular mesangial area and within the subcutaneous tissue. The treatment of HSPN based on clinical manifestations and renal pathology according to the different changes in the treatment of allergic purpura basis.2. Clinical retrospective study:The results further showed that,①The overall efficacy of the treatment group is superior to the control group (Z=-2.885, P<0.05).②After treatment, the syndromes efficacy of the treatment group is better than the control group (P<0.05). Total score of each syndrome effect, the treatment group than the control group (P<0.05), symptom scores were significantly lower than the control group, indicating integration of traditional and western medicine in purpura nephritis of children better than Western medicine syndromes treatment.③Side effects and complications of the treatment group were lower than the control group (X2=8.412, P<0.05). While all patients that treated with traditional Chinese medicine were not found associated with adverse reactions or side effects, the treatment of traditional Chinese medicine with Henoch-Schonlein purpura nephritis has better security.3. By comparing the different efficacy evaluation methods, combined with clinical, the establishment of a new evaluation of the efficacy of TCM system include:Clinical evaluation of diseases, Syndromes evaluation, Safety evaluation.Conclusion:Clinical efficacy of Integrated traditional Chinese and western medicine with purpura nephritis in children was better than the clinical efficacy of conventional western medicine treatment, side effects was lower than Western medicine alone with better security. A bear with the efficacy of TCM evaluation system should include:Clinical evaluation of diseases, Syndromes evaluation, Safety evaluation. Efficacy evaluation system of Chinese medicine and Modern medicine isn't impossible to communicate, and traditional Chinese medicine to maintain their efficacy evaluation should be based on the characteristics, efficacy evaluation of modern methods, ideas, and actively absorb the achievement of modern research, set up and improved medicine clinical evaluation of systems to its own characteristics. Therefore, TCM differential treatment of children with purpura nephritis and the clinical evaluation system of Chinese medicine should be further research and extension. |
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