| Purpose:In this study,the medical records of 156 patients with HSP in the Department of Dermatology of the Affiliated Hospital of Liaoning University of Traditional Chinese Medicine were collected,and the clinical data of HSP were retrospectively analyzed,in order to provide diagnosis and treatment ideas and references for the prevention and treatment of allergic purpura and kidney injury.Material and method:The clinical data of 156 patients diagnosed with HSP from January 2018 to January 2019 in the Department of Dermatology,Affiliated Hospital of Liaoning University of Traditional Chinese Medicine were retrospectively analyzed(the characteristics of the disease,laboratory examination,diagnosis classification,treatment and curative effect,etc.),and then the data were entered into Excel form for data analysis.Results:1.General information: A total of 156 HSP patients were included in this study,including 72 males(46.2%)and 84 females(53.8%),with a male to female ratio of 1:1.16.The youngest age at onset was 3 years old and the oldest was 68 years old.The average age at onset was(25.16±1.41)years old.Among them,68 cases(43.6%)of patients aged 0-15 years were higher than 32 cases in other age groups from 15 to 30 years old.(20.5%),32(20.5%)aged30-45,19(12.2%)aged 45-60,and 5(3.2%)aged 60-75.32(20.5%)patients had onset in spring,24(15.4%)patients had onset in summer,43(27.6%)patients had onset in autumn,and 57(36.5%)patients had onset in winter,and the incidence in winter was higher than in other seasons.The top five incident solar terms were Lidong(14 cases),Xiaohan(13 cases),Cold Dew(12 cases),rain(10 cases),and heavy snow(9 cases).46(29.5%)patients had a history of allergic diseases;2 patients(1.3%)had a family history of HSP;95(60.9%) patients had a clear incentive before the onset,and 57 patients were related to infection,including 46 patients with upper respiratory tract infection example.2.Clinical manifestations: In this study,there were 89 patients(57.1%)with skin purpura as the first symptom,21 patients(13.5%)with gastrointestinal symptoms as the first symptom,and a total of 21 patients(13.5%)with joint symptoms as the first symptom.9 cases(5.8%);156 cases(100%)of skin purpura occurred in both lower limbs,86 cases(55%)extended to the buttocks,and 42 cases(26.9%)extended to the upper limbs;70 cases had gastrointestinal symptoms,including 51 cases(72.9%)in the minor group and 19 cases(27.1%)in the adult group;46 patients had joint symptoms,including 30 cases(65.2%)in the minor group and 16cases(34.8%)in the adult group;8 cases The patients developed grade I edema of lower extremities,including 3 cases(37.5%)in the minor group and 5 cases(62.5%)in the adult group.3.Laboratory examination: Among the 91 patients with abnormal urine test(no renal function damage),45 patients(49.5%)only showed microscopic hematuria,31 patients(34.1%)only showed proteinuria,microscopic hematuria and proteinuria There were 15 cases(16.5%)at the same time.Routine WBC was elevated in 63(40.4%)patients,PLT was elevated in 58(37.2%)patients,and HGB was decreased in 26(16.7%)patients.4.Western medicine clinical classification: Among the 156 patients in this study,there were36 abdominal type,17 joint type,57 renal type,and 46 mixed type.Among them,there were29 cases of abdominal type,12 cases of joint type,20 cases of renal type,and 29 cases of mixed type in the minor group;7 cases of abdominal type,5 cases of joint type,37 cases of renal type,and 17 cases of mixed type in the adult group.The abdominal type and mixed type were more common in the juvenile group,and the renal type was more common in the adult group.5.TCM syndrome classification: Among the 156 patients,71(45.5%)had spots with blood heat,49(31.4%)had damp-heat and blood stasis,16(10.3%)had spleen deficiency,and yin deficiency and fire were prosperous.There were 20 cases(12.8%),and the TCM syndrome type of HSP was mostly blood heat with spots.6.Treatment situation: The top 20 flavors of traditional Chinese medicine decoction used in oral treatment are: Licorice,Rehmannia glutinosa,Poria,Cortex Moutan,Honeysuckle,Xiaoji,Alisma,Rhizoma Imperatae,Hengqi,Angelica,Fangfeng,Agrimony,Mystoma Ginseng,Forsythia,Chishao,Gardenia,Atractylodes,Codonopsis,tangerine peel,comfrey.Cluster analysis of 20 high-frequency drugs: C1: Shengdi,Poria,Xiaoji,Cortex Moutan;C2:Agrimony,Forsythia,Lithospermum,Gardenia,Imperatae;C3: Fangfeng,Honeysuckle;C4:Angelica,Hestilbene,Alisma: both qi and blood,diuresis and dampness;C5: Codonopsis,Scrophularia,red peony root,dried tangerine peel,Atractylodes.Use of Western medicines:antihistamines,vitamin C,compound glycyrrhizin,glucocorticoids,dipyridamole,rutin tablets,calcium,etc.7.Clinical efficacy: 156 patients,55 were cured,56 were markedly effective,40 were effective,and the total effective rate was 96.8%.Conclusion:1.In this study,Henoch-Schonlein purpura is more common in teenagers(5-15 years old),and it usually occurs in autumn and winter.The incidence may be related to genetic factors,infection,allergy and other factors.2.In this study,the kidney type is more common in the adult group,and the abdomen type is more common in the juvenile group.3.In this study,the main manifestation of HSPN patients is microscopic hematuria.4.In this study,blood-heat spotted syndrome and wet blood stasis syndrome are common TCM syndromes of HSP.5.In this study,oral Chinese medicine is mainly used to treat HSP,such as heat-clearing and blood-cooling drugs,qi-tonifying and hemostatic drugs,supplemented by blood stasis-removing drugs.6.The curative effect of Chinese and Western medicine in this study is definite. |
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