| Object:Through the statistical analysis to the sample collection of the medical cases ofHenoh-Schonlein purpura(HSP), from the children patients in the First AffiliatedHospital of Anhui University of Chinese Medicine during May,2009to December,2013, we summarized the medical characters of HSP and discussed the effects from thepatients’ age, gender, season of occurs, relative incentives. We also analyze the medicalcorrelation distribution between the symptoms and their medical classification, showingthe importance of lab test for the diagnosis of HSP. Overall, we hope this can help toimprove the efficient diagnosis and medical curing for the HSP.Methods:Applying the statistical analysis software SPSS18.0, using frequence as the main dataparameter, we analyze the differences between the distribution of the paticial medicalcases. Some groups using x2test for difference analysis, P<0.05shows a significantdifference while P<0.01shows insignificant difference. A part of urinalysis andurinary five proteins combination measurement tests using the same urine specimens,inspection results use Kappa test for consistency analysis, Kappa<0.4,shows a poorconsistency,0.4≤Kappa＜0.75,shows a ordinary consistency, Kappa≥0.75,shows a goodconsistency. Using diagnostic test, we compare the sensitivity of urinalysis andurinary five proteins combination measurement test.Results:1. The distribution of the medical syndrome classification of the HSP (in the order offrom high to low): Damp-Heat blocking syndrome with78.0%, Wind-Heat injurycollaterals syndrome with14.0%, Bleeding due to blood-heat syndrome with4.5%, QI can’t control blood syndrome with1%, edema with1%and hematuria with1.6%.2. The purpura can occur all over the body, typically appear on the legs, orsimultaneously on legs and buttocks, rarely appear on other places. HSP has relativelylarge number of complications, many patients suffer infection of the upper respiratorytract such as fever and cough; the abdomen type commonly involves emesis andstomachache; joint type’ characteristic symptom involves joint pain and muscularsoreness. Joint type often happen lower than the abdomen type. Besides, there is a fewcases, relatively rare, that show edema and pain at different parts through out the body.3. Syndrome distribution with gender: HSP occurs in both male and female, with ahigher chance of young male over young female (1.60:1).Damp-Heat blockingsyndrome is the most common syndrome over both genders. No particular dependenceon gender was found.4. Syndrome distribution with age: HSP occurs in all ages. Age2to8show highestincidence, with the group over8years old next to it. All syndromes occure mostly oftenin age2to8. while Damp-Heat blocking syndrome occures in all the three age groups.5. Syndrome distribution with season: HSP occurs in all the seasons, mostly often occurin the winter and spring. All the syndromes occur in all the seasons. Damp-Heatblocking syndrome shows a relatively high incidence in all the seasons, with a slightlyhigher preference of the spring and winter over the summer and fall. Wind-Heat injurycollaterals syndrome is more oftenly seen in the spring and summer than the fall andwinter. Bleeding due to blood-heat syndrome mostly occurs in the summer and fall.6. Incentives: The incentives of72.4%of the HSP children patients can be tracked,showing infection of the upper respiratory tract is the main incentive.88.6%of wind-Heat injury collaterals syndrome cases are triggered by the upper respiratory tract.Besides, a lot kinds of pathogenic microorganisms may incent the HSP.7. Chinese medicine syndrome type distribution with western medicine diagnosticclassification: The majority is related to kidney involvement. Over all the classification,the Damp-Heat blocking syndrome is the main type, among which the abdominal, jointplus kidney type combination is the most common type. The wind-Heat injurycollaterals syndrome is relatively common seen in skin type and kidney type. Overall,there is no obvious correlation between western medicine diagnostic classification andChinese medicine syndrome type.8. Auxiliary test for HSP: Most children patients show abnormal test result withurinalysis and urinary five proteins combination test; most abdomen type patients whoalso suffer gastrointestinal bleeding show positive reaction to stool ob test; most patientsalso show abnormal blood clotting function, appearing as different level of PLT and theincrease of FDP and D-Dimer level.Conclusion:1. Damp-Heat blocking syndrome is the mostly common syndrome among all thesyndrome types of the HSP.2. HSP occurs in both male and female, with a higher chance of young male over youngfemale. This project dose not confirm the gender dependence of the HSP.3. HSP occurs in all ages. Age2to8show highest incidence, with the group over8years old next to it, and the group under2years old is the lowest. All syndromes occuremostly often in age2to8. While Damp-Heat blocking syndrome occures in all the threeage groups. 4. HSP occurs, with a clear preference, in all the seasons, mostly often occur in thewinter and spring. All syndrome types exist in each season, while show differentpreference.5. The purpura can occur all over the body, typically appear on the lower part of thebody, usually happens with a varies types of accompanying symptoms and physical sign.Incentives exist for most of the children patients, among which the infection of theupper respiratory tract is the main incentive. Especially for wind-Heat injury collateralssyndrome, the infection of the upper respiratory tract is responsible for the majority ofthe cases. Besides, there are many kinds of pathogenic microorganisms may incent theHSP.6. The majority of the HSP cases are related to kidney involvement. Damp-Heatblocking syndrome remains the mostly common type among all kinds of the westerndiagnosis classifications, especially high in the combinations of abdomen type, jointtype and kidney type. Wind-Heat injury collaterals syndrome is relatively common seenin skin type and kidney type. This project does not show the correlation betweenwestern diagnosis classification and Chinese medicine syndrome type.7. The necessity of auxiliary test for HSP: most children patients show abnormal testresult with urinalysis and urinary five proteins combination test. In the diagnosis of HSP,the test result of the urinalysis and urinary five proteins combination test cannot replaceeach other. And the urinary five proteins combination test show higher sensitivity thanregular urinalysis. Most abdomen type patients who also suffer gastrointestinal bleedingshow positive reaction to stool ob test. Most patients also show abnormal blood clottingfunction, appearing as different level of PLT and the increase of FDP and D-Dimer level.Therefore, it is necessary for the HSP children to conduct the lab tests, which should be significant helpful for the diagnosis, treatment and prognosis. |
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