The Effect Of The Detoxication And Cooling And Activating Blood On The IL-17,MCP-1,TNF-? In The Plasma And Urine In Children With HSP And HSPN

1 Objective1.1 To provide clinical evidences of early prophylaxis and treatment for HSP and HSPN,the changes of IL-17 and MCP-1 and TNF-? in the plasma and TNF-? in the urine were under research to reveal the relationship with onset and illness.1.2 To provide scientific evidences of the application of combination of traditional Chinese medicine and western medicine in curing HSP and HSPN,the mechanism of the detoxication and cooling and activating blood and the potential role of the inflammation and hypercoagulability state were investigated,and the changes of IL-17,MCP-1,TNF-? and D-dimer in the plasma and TNF-? in the urine were under research.1.3 To estimate the effect of the detoxication and cooling and activating blood and the detoxicating and activating blood combined with Low molecular weight heparin calcium in curing HSP and HSPN,the TCM syndrome scoring and the treatment scoring were evaluated before and after treatment(at the point of run-in period,7thand 30thday).2 Method78 patients with HSP and HSPN coming from the frist ward of TCM-integrated pediatrics hospital of henan university of TCM were randomly allocated into HSP Chinese Medicine group(20 cases,compounded the detoxication and cooling and activating blood decoction and routine treatment),HSP Heparin combined with Chinese Medicine group(29 cases,added Low molecular weight heparin calcium to the detoxication and cooling and activating blood decoction and routine treatment),HSPN Heparin combined with Chinese Medicine group(29 cases,added Low molecular weight heparin calcium to the detoxication and cooling and activating blood decoction and routine treatment),in which the using of Low molecular weight heparin calcium is 7 days.The clinical investigating and the related marker testing were made in the run-in period,7th and 30 th day after randomization.And the healthy children acted as the normal control group(29cases).The following items were the details:? In run-in period,the general information of 29 healthy children and 78 patients with HSP and HSPN were analyzed,among which the differences of IL-17,MCP-1,TNF-? and D-dimer in the plasma,and TNF-? in the urine were investigated.? The TCM syndrome scoring and the treatment scoring were evaluated before and after treatment.To investigate the mechanism of the detoxication and cooling and activating blood and the potential role of the inflammation and hypercoagulability state in HSP and HSPN,the changes of IL-17,MCP-1,TNF-? and D-dimer in the plasma and TNF-? in the urine were under research.3 Results3.1 Therapeutic efficacy evaluationCompared with run-in period,the TCM syndrome scoring was declined,and the statistical significance was observed in HSP Chinese Medicine group in the 7th day and30thday(P<0.01),and it was same to HSP Heparin combined with Chinese Medicine group and HSPN Heparin combined with Chinese Medicine group.Compared with 7th day,the therapeutic efficacy was no statistical significance between HSP Chinese Medicine group and HSP Heparin combined with Chinese Medicine group in 30 th day(P>0.05).3.2 The results of cytokines in the plasmaIn run-in period,TNF-? in the plasma of HSPN patients was more higher than HSP patients,and the statistical significance was observed(P<0.05).There was no statistical significance between HSP group and HSPN group in IL-17,MCP-1 and D-D.Compared with run-in period,IL-17,MCP-1,TNF-? and D-dimer in the plasma were declined,and the statistical significance was observed in HSP Chinese Medicine group in the 7th day(P<0.05),and it was same to HSP Heparin combined with Chinese Medicine group and HSPN Heparin combined with Chinese Medicine group.There was no statistical significance between HSP Chinese Medicine group and HSPN Heparin combined with Chinese Medicine group in 7th day in IL-17,MCP-1,TNF-? and D-dimer in the plasma(P>0.05)?3.3 The results of cytokine in the urineCompared with the normal group,TNF-? in the urine of HSP group and HSPN group was higher in run-in period,and the statistical significance was observed(P<0.01).There was no statistical significance between HSP group and HSPN group(P>0.05).Compared with run-in period,TNF-? in the urine of HSP Chinese Medicine group was declined,and the statistical significance was observed in the 30 th day(P<0.05),and it was same to HSP Heparin combined with Chinese Medicine group and HSPN Heparin combined with Chinese Medicine group.4 Conclusion? It is the detoxication and cooling and activating blood that has shown efficacy in cure,and improves the TCM syndrome significantly at the early stage of the HSP and HSPN.It is effective in HSP both the detoxication and cooling and activating blood and the detoxicating and activating blood combined with Low molecular weight heparin calcium.? There is the inflammation and hypercoagulability state in HSP and HSPN.Both the detoxication and cooling and activating blood and the detoxicating and activating blood combined with Low molecular weight heparin calcium have effect in reducing the level of inflammatory cytokines and hypercoagulable index to relieving the inflammation and hypercoagulability state and obtaining satisfing effect.? HSP is a systemic vasculitis,act as the inflammatory hallmark at the acute stage,TNF-? in the plasma is sensitive to the state of illness,and can act as a sensitive hallmark in preventing and treating HSPN.And adjusting the level of TNF-? in HSP and HSPN can act as one of the mechanism in curing HSP and HSPN.