| Objective:In this study,we observed the changes of TCM symptom score,eosinophil count and Fas protein expression in peripheral blood of 70 children with Henoch Schonlein purpura nephritis treated by Zidian No.1 Prescription in Shenzhen Hospital of traditional Chinese medicine,evaluated the clinical efficacy of Zidian No.1 Prescription in the treatment of HSPN,and explored the mechanism of Zidian No.1 Prescription in the treatment of HSPN from the cellular and molecular level.Methods:Using random number table method,35 cases in the control group and 35 cases in the treatment group were set up.The blood routine,urine routine,urine biochemical and Fas surface antigen expression of peripheral blood eosinophils were detected in the two groups at 0,4,8 and 12 weeks.In addition,the TCM syndrome score was performed,and the effective rate before and after treatment and the changes of relevant observation indexes were analyzed.The observation group was treated with oral Chinese medicine,and the basic formula was Zidian No.1 Prescription;the control group was treated with western medicine.Record the general situation of children at each time point,efficacy related indicators,laboratory indicators,and establish a database,use statistical methods for data processing,and finally get the results and discuss.Results:①Baseline data comparability:there was no significant difference in gender,age,weight,course of disease,TCM syndrome score(main and secondary syndrome score)at week 0 between the two groups and laboratory examination at week 0(P>0.05).② The total score of TCM symptoms:compared with the control group,the total score of TCM symptoms in the treatment group had significant difference in the fourth week(P<0.01),but there was no significant difference in the eighth week and the twelfth week(P>0.05),There was significant difference between the two groups(P<0.01).③ In terms of TCM main symptom score:Purpura distribution,purpura morphology:compared with the control group,the treatment group had significant difference in purpura distribution and purpura morphology score at the fourth week(P<0.05).There was no significant difference between the 8th and 12th week(P>0.05).Purpura color:compared with the control group,the treatment group had no significant difference in the 4th,8th and 12th week(P>0.05).④ In terms of TCM syndrome score:Hematuria:compared with the control group,the treatment group had significant difference in hematuria score at the 4th week(P<0.05);there was no significant difference at the 8th week and the 12th week(P>0.05).Abdominal pain,joint pain:compared with the control group,the treatment group had no significant difference in the 4th,8th and 12th week(P>0.05).⑤ Clinical efficacy:compared with the control group,there was no significant difference in the clinical efficacy of the treatment group at the 4th,8th and 12th week(P>0.05).⑥ In the aspect of peripheral blood EOS:compared with the treatment group,the control group had significant difference in reducing peripheral blood EOS at the 4th week(P<0.05);compared with the treatment group,the treatment group had no significant difference in reducing peripheral blood EOS at the 8th and 12th week(P>0.05).⑦ Fas protein expression on the surface of EOS in peripheral blood:compared with the treatment group,the Fas protein expression on the surface of EOS in peripheral blood of the control group increased significantly at the 4th week(P<0.05);compared with the control group,the Fas protein expression on the surface of EOS in peripheral blood of the treatment group increased significantly at the 12th week(P<0.05).Compared with the control group,the treatment group had no significant difference in the 8th week(P>0.05).⑧ In terms of early renal damage indicators:mALb、β2-MG、NAG,compared with the control group,the treatment group had significant differences in the 4th,8th and 12th week(P<0.05).Conclusion① Compared with the western medicine control group,Zidian No.1 Prescription can improve the clinical symptoms of HSPN children in the early stage,especially in the distribution,morphology and hematuria of purpura;compared with western medicine,Zidian No.1 Prescription has a faster effect and longer effect on improving early renal damage index.② Western medicine control group was better than traditional Chinese medicine control group in reducing EOS and increasing Fas antigen expression in peripheral blood at the early stage of treatment(4th week).However,with the continuation of treatment,Zidian No.1 Prescription was better than western medicine in increasing Fas antigen expression on EOS surface at 12th week of treatment.③ The mechanism of HSPN treatment in the control group and the treatment group may promote the expression of Fas antigen on the surface of EOS,promote the apoptosis of EOS,and reduce the damage of immune to renal tissue.However,compared with the control group,the treatment group may have more mechanisms to be studied. |
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