Clinical Evaluation Of Simiaosan Jiawei Powder In The Treatment Of Humid-Heat Syndrome In Children With Henoch-Sch(?)nlein Purpura Nephritis And Experimental Study

Objective:To analyze the clinical efficacy of Simiaosan Jiawei powder in treating the Humid-Heat syndrome of HSPN in children,and preliminarily explore its therapeutic mechanism through animal experiments.Methods:1.Clinical study: Using a self-controlled study method,cases meeting the inclusion criteria were treated with Chinese medicine Simiaosan Jiawei powder on the basis of western medicine for 4 weeks.The changes of 24-hour urine protein quantification,urine routine red blood cell count,TNF-α,IL-6 and TCM evidence score and other observation indexes were observed before and after the treatment.SPSS27.0 were used for data processing and analysis of clinical efficacy.2.Experimental study: SD rats were randomly selected 10 as the blank control group and 40 as the model group,and the experimental Ig A nephropathy model was replicated according to the method of BSA+LPS+CCl4.After the successful evaluation of the model group,the model group was randomly divided into 4 groups,including the model control group,the low,medium and high dose groups of Simiaosan Jiawei powder,10 rats in each group,and the changes of serum TNF-α,IL-6,BUN,Scr and 24-hour urine protein quantification were observed before and after treatment.Results:1.In the clinical study,24-hour urine protein quantification,routine urine red blood cell count,serum TNF-α and IL-6 were significantly improved after treatment compared with those before treatment,and the difference was statistically significant at P <0.01.Among the TCM symptoms,the major symptoms: hematuria,proteinuria,and foam in urine was significantly reduced after treatment compared with those before treatment,and the difference was statistically significant;among the minor symptoms,except for skin nail fault,which did not improve significantly,P=1>0.05,the remaining symptoms were significantly reduced after treatment compared with those before treatment,P<0.05,and the difference was statistically significant,among which fever,arthralgia,and abdominal pain were completely eliminated after treatment.The symptoms completely disappeared after treatment.Western medicine disease efficacy analysis,total effective rate 100%;Chinese medicine evidence efficacy evaluation,total effective rate 98.39%.2.Experimental study: Comparison between groups: Compared with the model control group,serum TNF-α,IL-6,BUN,Scr and 24-hour urine protein quantification were significantly lower in the rats in the low,medium and high groups of Simiaosan Jiawei powder,P < 0.05,with statistically significant differences.Intra-group comparison: serum TNF-α,IL-6,BUN,Scr and 24-hour urine protein quantification were significantly lower in the rats in the middle dose group of Simiaosan Jiawei powder compared with the low dose group of Simiaosan Jiawei powder,P<0.05;serum TNF-α,IL-6,BUN,Scr and24-hour urine protein quantification were significantly lower in the rats in the high dose group of Simiaosan Jiawei powder compared with the middle dose group of Simiaosan Jiawei powder,P<0.05.P<0.05,the difference was statistically significant.Conclusion:1.Clinical study: Simiaosan Jiawei powder can reduce 24-hour urine protein quantification,urine red blood cell count and serum TNF-α and IL-6levels as well as improve the main clinical symptoms in children with HSPN damp-heat internalized evidence,and no adverse effects on liver and kidney function were found.2.Experimental study: Simiaosan Jiawei powder can reduce TNF-α and IL-6levels,inhibit inflammatory response,improve serum BUN and Scr levels,and reduce 24-hour urine protein quantification in rats,and it has a certain quantitative-effect relationship.The mechanism of efficacy is related to the inhibition of pro-inflammatory factors IL-6 and TNF-α release,thus reducing the inflammatory response of the kidney.