The Clinical Research On The Treatment Of Children With HSP By The Way Of Expelling Wind And Nourishing Yin

Objective This study is aimed at comparing curative effects of pediatric allergic purpura which were treated with huaiqihuang particles to expelling wind and nourishing yin on the base of western medicine and with western medicine alone,exploring the possible mechanism of expelling wind and nourishing yin on allergic purpura,seeking a kind of effective and security therapy in treating children with henoch-schonlein purpura to provide an optimal treatment program.Method 200 cases meeting the standard were selected from Dermatology and Chinese medicine outpatient and Kidney internal medicine inpatient of Dalian children's Hospital,They were randomly divided into observation group and control group.Western medicine basic treatment: vitamin C,rutin tablets,loratadine tablets conventional oral;if there exists significant infection,given effective antibiotics;application of glucocorticoids when necessary.(Adrenal glucocorticoids application specification:Dexamethasone 0.25-0.75mg/kg intravenously or prednisone 1-1.5mg/kg orally for moderate to severe gastrointestinal bleeding or angioneurotic edema.)observation group: give Huaiqihuang particles(10g/pack)1pack twice daily on the basic of western medicine above.course of treatment : 4 weeks for a course of medication and continuned three courses and followed up for one year.The two groups of clinical efficacy,time of main symptoms disappeared,recurrence rate,and the situation of purpura nephritis in both groups at the end of treatment were compared.The levels of cellular immunity,serum and urinary HGF were observed before and after treatment in both groups.Result1.From the aspect of total clinical efficacy,the total effective rate of the observation group accounted for 94.0%,the total effective rate of the control group accounted for 73.0%,the difference was statistically significant,P <0.001,suggesting that the clinical efficacy of the observation group was significantly better than the control group.2.From the aspect of the disappearance time of two main symptoms,after examination,the differences between two groups of the disappearance time of purpura and abdominal pain were statistically significant,P<0.05.The results showed that the observation group was better than the control group in the disappearance time of purpura and abdominal pain.The disappearance time of joint pain was compared,P > 0.05,there was no significant difference between the two groups.3.From the aspect of the situation of purpura nephritis at the end of the treatment,the degree of HSP with renal damage in the observation group was lighter than that in the control group,the number of cases of HSPN was less than in the control group.4.In the comparison of changes in serum and urinary HGF levels between the two groups before and after treatment,the difference of the baseline level betwen the two groups before treatment was not statistically significant.compared with the group before treatment,the levels of serum and urine HGF in the two groups were lower than those before treatment(P <0.05),but the total reduction of serum and urinary hepatocyte growth factor in the observation group was significantly higher than that in the control group before and after treatment.5.At the end of treatment,the levels of CD4+ and CD8+ in peripheral blood were compared between the two groups before and after treatment,There was significant difference between the two groups(P <0.05),but the level of CD4+,CD8+ and CD4+ / CD8+ in observation group was significantly higher than that in control group(P <0.01),suggesting that the adjustment of cellular immunity in the observation group is more obvious than that in the control group,P <0.05.6.The recurrence rates of the two groups showed:The relapse rate was 4% in the observation group and 24% in the control group,P <0.001,the difference was statistically significant,indicating that the relapse rate in observation group was significantly lower than that in control group.Conclusions 1.The clinical comprehensive effect of Expelling wind and nourishing yin treatment of children with HSP is significant,It can significantly shorten the disappearance time of purpura and abdominal pain symptoms,shorten the duration of symptoms.2.Expelling wind and nourishing yin treatment of children with HSP,through adjusting the children's cellular immune function,enhancing the ability of children to resist and prevent disease,significantly reduce the recurrence rate,effectively prevent the occurrence of HSPN.3.Dynamic monitoring of serum and urine HGF during the treatment of HSP may play an important role in judging the condition.It is presumed that the possible mechanism of huaiqihuang which can expelling wind and nourishing yin in treating HSP is through the influence of serum and urinary HGF level to play the role of anti-inflammatory and repair damaged endothelial cells.4.Taking expelling wind and nourishing yin as the treatment principle,the application of Chinese medicine preparation " huaiqihuang particles " treatment of children with HSP is safety and little side effects,easy to carry,good-tasting,acceptable for children,and compliable for parents,in this way,it can be widely promoted in the clinical treatment of HSP.