| Study Background and Objective: Henoch-Schonlein Purpura (HSP) is asyndrome which is characterized by skin purpura, hemorrhagic gastroenteritis, arthritisand kidney damage. The basic lesion is diffuse systemic necrotizing vasculitis. Therenal damage which calls Henoch-Schonlein Purpura Nephritis (HSPN) is a secondarycomplication of HSP. The annual disease incidence of HSP is around10-18/100000, theincidence also shows an increasing trend in recent years. HSPN ranks as the first placeof children secondary nephritis. It’s also the most important factor which affectspatients’ prognosis. Currently with the conventional therapy, part of the HSPN patientscan be cured. However about15%of the children patients will have persistent kidneydamage.8%of the children patients may have renal failure, the prognosis of HSPNadult patients is even worse. Even if HSPN gets completely recovered or mind kidneydisease in early onset, the recovery of HSP is not optimistic in a long-term point of view.Therefore, in the process of HSP treatment, regardless of the severity of kidney damage,it’s important to pay attention to the treatment of kidney lesions. According to theroutine urine examination, there are around20%-60%HSP children who have HSPN.And according to renal biopsy, there are around90%-100%HSP children who haveglomerular inflammatory lesions. It indicates that the detection rate of the routine urinetest is low, and the penetration of renal biopsy is not wide, therefore, it’s important tofind a convenient and sensitive detection way for HSPN. The purpose of this study is toinvestigate the efficacy of Yishen Xiaodian Prescription that principles of formulatingprescription by eliminating dampness with aromatics, clearing heat and cooling blood,tonifying kidney and promoting blood circulation on the treatment of Henoch-SchonleinPurpura Nephritis and the clinical significance for the observation of urine trace proteinfor HSPN patients. Methods: These cases were chosen by the outpatients and inpatients from the210Hospital of PLA during the period of Jan2008–Dec2011. The total75patients havebeen randomly separated with the treating group (42HSPN patients) and control group(33HSPN patients). Compare with the control group who were treated by the purewestern medicine therapy, the patients in the treating group were treated by the samewestern medicine therapy and the Yishen Xiaodian Prescription.4weeks for a course oftreatment,3months,6months,9months and12months as the nodes, we observed thetreatment efficacy for the two groups. With the treatment of the Yishen Xiaodianprescription for6-12months when the patients in the treating group have normal routineurine test. Observed and recorded the changes of routine urine test (occult blood,protein),24-hour urinary protein excretion, urinary albumin, β2-microglobulin, andretinol binding protein. The experimental data was processed by SPSS18.0statisticalsoftware, the measurement data was using the t-test and the count data was using thechi-square test. It has statistical significance in P<0.05.Result:1. After a12-month treatment, the effective rate for the treating group is80.95%and69.69%for the control group. The Difference between the two group wasstatistically significant (P<0.05).2. A24-month follow-up for the treating group showsthe total clinical cure rate is92.85%, the relapse rate is just7.14%. When the urineprotein and urine occult blood were negative,38.09%patients had24-hour urinaryprotein excretion increased, and90.47%patients had abnormal urine trace protein. Allthe patients had normal24-hour urinary protein excretion after9months of thetreatment as of the routine urine test became normal, however45.23%patients still hadabnormal urine trace protein.Conclusion:1, The Yishen Xiaodian Prescription that principles of formulatingprescription by eliminating dampness with aromatics, clearing heat and cooling blood,tonifying kidney and promoting blood circulation has great clinical efficacy for HSPNwith a lower recurrence rate.2, The prescription effectively eliminates urine protein andoccult blood, tapers the24-hour urinary protein excretion and trace protein (microalbumin, β2-microglobulin, retinol binding protein), promotes the repair of renaldamage.3, HSPN patients are highly sensitive with urine trace protein, so the urinetrace protein can be used as HSPN early diagnosis and treatment criteria. |
