| Objective: By observing HSP childrens,incidence of kidney damage after treatment with two solutions,classify and analysis the data to compare the rates of kidney damage when they were in different condition,the degree of abdominal pain and treatment,understanding the correlation between Childrens’ with HSP urinary EGF and serum VEGF and kidney damage.Methods: Collected through cohort study between January 2014 and December 2014 respectively in henan college of traditional Chinese medicine the first affiliated hospital of pediatrics ward and zhengzhou city children’s hospital kidney rheumatology into standard HSP children 1010 cases(731 cases of hospital group,children’s hospital group,279 cases),respectively,according to the condition of integral divided into light and heavy, They were given the two solutions as step treatment: scheme 1:light with syndrome differentiation + danshen preparations+ heparin,heavy plus hormone, when it is necessary to add TW preparations, scheme 2: light with vitamin C+ Calcium supplements + shu xuening, heavy added hormone,Cases in scheme 1 sourced first affiliated hospital, henan institute of traditional Chinese medicine,cases in scheme 2 sourced at children’s hospital of zhengzhou city,all children admitted to in hospital treatment and outpatient follow-up on a regular basis,a total of 12 weeks,the emphasis on before treatment,2,4,6,8 weeks checking blood,urine routine,liver and kidney function,24 hours urinary protein quantitative,in 12 weeks to check blood,urine routine,prior to the treatment and follow-up of renal injury(1weeks testing) serum vascular endothelial growth factor(VEGF) and human epidermal growth factor(EGF).Results:(1) After treatment with the two methods overall kidney injury situation: renal injury incidence: After the treatment with the scheme 1 kidney injury rate was 13.82%(101/731),Scheme 2 kidney injury incidence was 18.64%(52/279),The difference was no statistically significant(P > 0.05); the degree of kidney damage:After the treatment with the scheme 1 light,medium and severe kidney damage rate were 50.5%(51/101),39.60%(40/101),9.9%(10/101),Scheme2 respectively were 46.15%(24/52),30.77%(16/52),23.08%(12/52),the difference between light + moderate and severe after treatment with the two methods was statistically significant(P<0.05);kidney injury time: After the treatment with the scheme1 renal involvement was(52.48±31.44) days,Scheme 2 was(40.39±27.18) day, the difference between them was statistically significant(P<0.05),the time distribution: The rates of<2 week,2 weeks to 2 months,2-3 month were 5.88%(9/153), 73.20%(112/153),20.92%(32/153).(2)(TW) compared with the TW preparation group: TW preparation group of renal damage rate was 16.94%(41/242),the TW preparation group was 12.27%(60/489), the difference between them was statistically significant(P>0.05); Renal damage degree: light and medium +severe in TW preparation group of kidney damage rates were 56.10%(23/41),43.90%(18/41),the TW preparation group were 25.00%(15/60),75.00%(45/60), the difference between them was statistically significant(P<0.05),renal involvement time TW preparation group was(51.86±29.80) day,the TW preparation group was(46.69±28.25)day,there was no statistically significant difference(P>0.05).(3)The comparison between renal injury of different abdominal pain and illness and clinical classification: all children both groups with light,medium and severe abdominal pain incidences of renal injury were 6.87%(9/131),16.96%(38/224),37.38%(40/107),compared medium and heavy children with abdominal pain with light they was statistically significant(P<0.05);light and heavy disease rate of renal loss in two hospitals were 12.79%(78/610) and 18.75%(75/400),the difference was statistically significant(P<0.05), the rates of renal loss of light and heavy disease in two hospitals were 12.79%(78/610) and 18.75%(75/400), the difference was statistically significant(P <0.05); Light HSP children: in traditional Chinese group and children’s hospital renal loss rates were 12.31%(56/455),14.19%(22/155),There was no statistically significant difference(P>0.05); Heavy children with HSP: in traditional Chinese group and children’s hospital renal loss rates were 16.30%(45/276), 24.19%(30/124), there was no statistically significant difference(P>0.05); Kidney injury incidences of different clinical classification: kidney damage rates of the skin, joints, stomach type, mixed type were11.16%(24/215),12.61%(42/333),19.61%(41/209)and18.18%(46/253), abdomenal type and mixed type,respectively,compared with skin type,The difference was statistically significant(P<0.05).(4) when children in two hospitals were given different treatment kidney injury situation: Light illness HSP children: plan1, 2 renal loss rates after treatment were 12.31%(56/455), 14.19%(22/155),There was no statistically significant difference(P > 0.05); Heavy illness children with HSP: plan 1, 2 renal loss rates after treatment were 16.30%(45/276), 24.19%(30/124), There was no statistically significant difference(P >0.05);Heavy HSP children in traditional Chinese group respectively were given syndrome differentiation+danshen preparations+heparin+ hormone and syndrome differentiation + danshen preparations+heparin + hormone + TW preparations, the rates of renal loss were16.74%(40/239),13.51%(5/37),there was no statistically significant difference(P>0.05).(5) Compare different groups of urinary EGF, serum VEGF,kidney damage and non-renal damage group disease early(before treatment) of urinary EGF,respectively[(90.32±42.95)ng/m L],[(94.21±43.04)ng/m L],two groups of serum VEGF respectively were[(83.18±62.03)ng/L] and [(92.03±63.37) ng/L],Urinary EGF,serum VEGF in two groups were no statistically significant difference in early disease(P>0.05);Two different indicators in the clinical classification there was no statistically significant difference(P>0.05);Serum VEGF with gastrointestinal symptoms group[(120.17 ± 75.53)ng/L]was higher than no gastrointestinal symptoms group [(87.85±48.49)ng/L],The difference was statistically significant(P<0.05); urinary EGF and serum VEGF of early renal damage group(kidney damage within 1 week) compared with before treatment group,The difference was statistically significant(P<0.05).Conclusions:(1)The incidences of HSP kidney damage after treatment with the two methods were lower than the literature reported, renal damage rate of ladder treatment combined traditional Chinese and western medicine was lower, prompting the effective prevention of renal injury.(2)in terms of clinical symptoms,abdominal type and hybrid ratios were higher than the rest of the two types of kidney injury,abdominal pain is more serious,renal damage ratio is higher; Heavy children with HSP kidney injury incidence was higher than light.(3) In traditional Chinese hospital tripterygium wilfordii agents and foundation treatment can effectively reduce the HSP degree of kidney damage.(4)Urine EGF, serum VEGF can be used as a testing index of complicated with renal injury in the early allergic purpura. |
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