| BackgroundAnaphylactoid purpura(AP),known as Henoch-Sch(?)nlein purpura(HSP),is a systemic small vasculoinflammatory disease mediated by immune complex,which clinical manifestations often accumulate in the skin,gastrointestinal tract,kidney,even the heart,brain and other organs.The incidence of HSP in China is increasing year by year,and the accompanying symptoms are more frequent,which brings some troubles to the diagnosis and treatment of clinicians.About the pathogenesis of HSP,leukotriene can induce and activate a variety of immune responses,increase vascular permeability,aggravate vascular endothelial injury,and cause microvascular necrotizing inflammatory response.The intestinal mucosal epithelium of the body is also damaged,resulting in the reduction of its biological barrier,immune barrier and mechanical barrier functions.At the same time,the colonization of beneficial bacteria is reduced,resulting in the imbalance of intestinal flora,which can’t effectively curb the invasion and colonization of harmful bacteria and aggravate the immune response.In the previous treatment,we believe that leukotriene antagonists help to inhibit immune response,but ignore the importance of intestinal microbial homeostasis for HSP treatment.Therefore,it is necessary to explore the clinical effect of probiotics or both in the treatment of HSP.ObjectivesTo explore whether montelukast sodium combined with Clostridium butyricum combined with live bacteria powder is better than single drug in the treatment of children with HSP.MethodsA randomized controlled trial design was used in this study.From June 2018 to June2020,220 children with HSP treated for the first time in pediatrics of the First Affiliated Hospital of Xinxiang Medical University were included in the study.They were randomly divided into control group,montelukast group,Clostridium butyricum group and combination group,55 cases in each group.The control group was given clinical conventional treatment,the montelukast group was given combined montelukast sodium chewable tablets on the basis of conventional treatment,the Clostridium butyricum group was given combined Clostridium butyricum combined viable powder on the basis of conventional treatment,and the combined group was given combined montelukast sodium chewable tablets and Clostridium butyricum combined viable powder on the basis of conventional treatment.The primary outcomes are the effective rate and the disappearance time of skin purpura symptoms.The secondary outcomes are as follows: the duration of disappearance of abdominal pain and joint swelling and pain;changes of leukocytes,neutrophils,eosinophils,immunoglobulin A(IGA),immunoglobulin G(Ig G),immunoglobulin M(Ig M),complement C3,complement C4 and C-reactive protein(CRP).ResultsWhen children with HSP were treated with routine treatment group,montelukast sodium group,clostridium butyricum group and combination group,the disappearance time of skin purpura symptoms were 11.23±4.57,7.46±2.09,6.82±3.77 and 5.32±3.31 respectively.It was found that the disappearance time of skin purpura symptoms in combination group was the shortest and the effect was the best(P < 0.001).The effective rates of conventional treatment group,montelukast sodium group,Clostridium butyricum group and combined treatment group in the treatment of children with HSP were 80.77%,94.00%,96.00% and 98.00% respectively.It was found that the effective rate of combined treatment group was higher than that of conventional treatment group(P = 0.005).ConclusionsCompared with single intervention groups,the results showed that the disappearance time of skin purpura symptoms was the shortest,and the effective rate in the treatment of children’s HSP was the highest,suggesting that the combination of drugs has a better effect in the treatment of children’s HSP than conventional treatment. |
