| Purposes:The study is to prove the clinical effect of Mongolian medicine on HSPN. We also aim to provide research foundation and objective basis for establishing the diagnosis standard of HSPN. Furthermore, this study is to supply the experimental evidences for the objectification of Mongolian medical research and to promote the modernization process of Mongolian medicine for the treatment of HSPN, through observing the correlation of D-dimer, HP detection, serum VCAM1,VEGF and HSPN.Methods:In this study, cross-sectional and prospective study method were used. Specifically, a total of 128 patients with HSPN conforming to the diagnostic criteria of HSPN were selected and divided into two groups, mild and severe, according to their severity of symptom. Then, all the two groups of patients were also divided into treatment and control groups randomly. The mild patients in the treatment group were treated with Mongolian medicine while they in the control group were treated with western medicine. The severe patients in the treatment group received the combining of Mongolian and western medicines, while they in the control group received only western medicine. Simultaneously, the diagnostic and disease observation approaches of traditional Mongolian medicine, such as "urine diagnosis" and "bloated eight area" were used to compare the correlation between the laboratory test index, serum D-dimer, HP detection result, VCAM 1, VEGF and the occurrence and progress of HSPN, and the relevance of Mongolian and western medicines before and after the treatment. Statistical analysis was carried out using SPSS 19.0. Descriptive and relativefrequencies were used for the analysis of HSPN clinical data. Measurement data was analyzed by two independent samples nonparametric rank and inspection. Rank sun test was done for analyzing the level data and X2 and t-test were used for the count data analysis.Results:1.General situation:All of 128 patients had no significant statistical differences in age and gender (P>0.05). So, they were comparable. The data of these four groups showed that the difference before and after the treatment was statistically significant according to traditional Mongolian disease observation methods (P<0.05). Consistently, symptoms were improved significantly after the treatment.When comparing the two groups of data either before or after the treatment respectively, there was no significant difference (P>0.05). In addition, the data was declined with the improvement of symptoms,demonstrating that the traditional Mongolian observation methods were accurate. workable, and scientific.2. Lab. routine test result and clinical curative effect comparison:For the severe patients, no significant statistical difference between the treatment and control groups (P>0.05) was found when comparing the rate of urine occult blood becoming negative through urine routine test. Heavy protein overcast rate of severe patients in the treatment group was significantly better than those in the control group (P<0.05). However, the difference of the half quantity loss of urinary protein content in 24 hours between the treatment and control groups of severe patients was not significant (P>0.05). As to the patients with mild symptom, the rate of urine occult blood becoming negative in the treatment group was significantly better than the control group (P<0.05). The total cure rate of both mild and severe patients in the treatment group was significantly higher than those in the control group (P<0.05). Blood lipid in severe patients in the treatment and control groups were compared before and after the treatment and no significant statistical difference was observed (P>0.05).In drug side-effect analysis, obvious statistical difference in the severe patients, but not in the mild patients was observed. The drug side-effect in the control group was obviously higher than that in the treatment group, demonstrating that drug side-effect in severe patients in the control group was relatively high. The comparison result of half year relapse rate among all patients exhibited that it was significantly higher in the control group than that in the treatment group (P<0.05).3. Research on the correlation of serum cytokines and disease:It was comparable because there was no significant statistical difference in age and gender among all of the 128 patients (P>0.05). The level of serum D-dimer, HP, serum VCAM 1, and VEGF was found to be significantly higher in the severe patients than that in the mild patients. Additionally, this difference was also observed between patients and healthy groups (P<0.05). The level of serum D-dimer was comparably higher in the severe patients by contrast to that in mild patients before the treatment (P<0.05). The result from the analysis of half-year relapse rate showed that this disease was more likely to recur among HP positive patients than HP negative patients (P<0.05).The amount of serum VCAM-1 and VEGF in patients in the mild and severe groups before treatment was significantly different (P<0.05). Also, the content of serum VCAM-1 and VEGF in the patients in either mild or severe groups differs significantly before and after the treatment, indicating that serum VCAM 1 and VEGF had positive correlation with the severity of HSPN.Conclusions:1. The results from this study verified that the traditional Mongolian medicine diagnosis such as "urine diagnosis"and "bloated eight area" was operational and scientific in clinic. It also supplied the evidences for further study on the characteristics of Mongolian medicine disease symptom.2. Purpura nephritis in childhood is a complicated autoimmune disease caused by various factors, with intricate clinical symptoms. The inconsistency of clinical symptoms, medical laboratory results, and kidney pathology made the difficulties for the clinical treatment. In addition, current pharmacotherapy has high drug side-effect, but its clinical curative effect is very low. Consequently, a unified and effective treatment still has not been developed.Mongolian medicine refers to the human body as a whole. It integrates and analyzes the complicated clinical symptoms, and simply differentiates the diseases based on the theory of Mongolian medicine. It has a good clinical curative effect on dialectically treating purpura nephritis of children, indicating that the Mongolian medicine has rich theoretical basis for treating purpura nephritis in children. It provides the scientific evidences for differentiation of symptoms and signs and objectified research of clinical medication for children with purpura nephritis. It will be of great importance in popularizing Mongolian medicine in clinic, because of its lower side-effect and higher curative effect.3. The children suffering from purpura nephritis had raised level of D-dimer, VCAM 1 and VEGF. Therefore, D-dimer, VCAM 1 and VEGF can be used as indicators in diagnosis and progression of purpura nephritis in children. The rate of HP positive patients displayed obvious correlation with the recurrence. So, it can be used as the evaluation of prognosis of purpura nephritis in children.As a conclusion, the results of this study provided the objective basis for the clinical classification of treatment and prognosis factors judgment in childhood purpura nephritis at micro-level. |
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