本文選題：復(fù)方甘草酸苷 + 過敏性紫癜�。� 參考：《南昌大學(xué)》2017年碩士論文

【摘要】：目的:過敏性紫癜(HSP)是一種兒童期多見的全身性小血管炎,病因復(fù)雜,主要臨床表現(xiàn)為雙下肢為主的特征性皮疹,高出皮面,壓之不退色,多伴有消化道、關(guān)節(jié)和腎臟等多系統(tǒng)損害,如不及時(shí)治療,病情加重可出現(xiàn)消化道出血、腸套疊、失血性休克、腎功能衰竭等嚴(yán)重并發(fā)癥,危及患兒的生命安全。其病程數(shù)日至數(shù)年不等,近期預(yù)后與消化道癥狀有關(guān),長(zhǎng)期預(yù)后取決于其腎損害的嚴(yán)重程度[1,2],一般預(yù)后良好。目前其致病機(jī)制尚不明確[3-5],亦無特效的治療方法。許多研究表明,T細(xì)胞亞群的功能失衡極大可能參與了其發(fā)病機(jī)制。本文旨在通過觀察復(fù)方甘草酸苷治療過敏性紫癜的臨床效果和不良反應(yīng),并測(cè)定趨化因子受體CCR3、CCR5水平的變化,探討過敏性紫癜的發(fā)病機(jī)制以及證實(shí)復(fù)方甘草酸苷治療過敏性紫癜(HSP)的療效。方法:選取收治的40例過敏性紫癜患兒,根據(jù)就治順序編號(hào),采取隨機(jī)數(shù)字表法分為2組,即對(duì)照組和治療組,每組各20例,給予對(duì)照組常規(guī)治療,治療8天。治療組則在常規(guī)治療的基礎(chǔ)上使用復(fù)方甘草酸苷(1~2mg/kg.d,最大量2mg/kg.d,不超過20mg),一天一次,治療8天。此外篩選同時(shí)期20例健康體檢兒童作為健康組。通過流式細(xì)胞儀測(cè)定健康組及紫癜組(對(duì)照組和治療組)治療前后的趨化因子受體CCR3、CCR5水平,并記錄治療組和對(duì)照組各自的臨床癥狀緩解(消退)時(shí)間,觀察有無不良反應(yīng)。結(jié)果:1、臨床療效:治療組顯著優(yōu)于對(duì)照組,經(jīng)統(tǒng)計(jì)學(xué)比較,p0.05,存在明顯差異。2、臨床癥狀緩解(消退)時(shí)間:治療組短于對(duì)照組,差異有統(tǒng)計(jì)學(xué)意義(p0.05)。3、紫癜組與健康組比較,CCR3水平明顯升高,CCR5水平明顯下降,比較均存在極大差異(p0.05)。4、紫癜組治療前后比較,治療后CCR3水平降低,CCR5水平升高,比較有統(tǒng)計(jì)學(xué)意義(p0.05),治療組差異大于對(duì)照組。5、兩組在治療中及治療后均未見不良反應(yīng)。結(jié)論:1、相比于健康組,HSP患兒CCR3水平升高,CCR5水平降低,說明HSP患兒體內(nèi)存在Th1/Th2失衡,Th2優(yōu)勢(shì)表達(dá)。2、治療后紫癜組,CCR3水平降低,CCR5水平升高,治療組差異顯著,復(fù)方甘草酸苷對(duì)HSP的作用機(jī)制可能通過下調(diào)CCR3表達(dá),上調(diào)CCR5表達(dá)來調(diào)節(jié)Th1/Th2失衡,從而發(fā)揮免疫調(diào)節(jié)作用。3、復(fù)方甘草酸苷治療HSP療效顯著,副作用少。
[Abstract]:Objective: Henoch-Schonlein purpura (HSP) is a common systemic vasculitis in childhood with complicated etiology.Severe complications such as gastrointestinal bleeding intussusception hemorrhagic shock renal failure and other serious complications such as joint and kidney damage such as failure to treat the disease in time may lead to serious complications such as gastrointestinal bleeding intussusception hemorrhagic shock renal failure and so on which endanger the life and safety of children.The course of disease varies from several days to several years. The short-term prognosis is related to the symptoms of digestive tract. The long-term prognosis depends on the severity of renal damage, and the general prognosis is good.At present, the pathogenesis of the disease is not clear [3-5], and there is no effective treatment.Many studies have shown that the functional imbalance of T cell subsets may be involved in its pathogenesis.The aim of this study was to observe the clinical effects and adverse reactions of compound glycyrrhizin in the treatment of Henoch-Schonlein purpura, and to determine the level of CCR3 and CCR5, a chemokine receptor, in the treatment of allergic purpura.To investigate the pathogenesis of Henoch-Schonlein purpura and the efficacy of compound glycyrrhizin in the treatment of Henoch-Schonlein purpura.Methods: 40 children with Henoch-Schonlein purpura were randomly divided into two groups: control group (n = 20) and treatment group (n = 20).The treatment group was treated with compound glycyrrhizin 1 2 mg / kg 路d, with a maximum dose of 2 mg / kg 路d, no more than 20 mg / d, once a day for 8 days.In addition, 20 healthy children in the same period were selected as healthy group.The levels of CCR3- CCR5, a chemokine receptor, were measured by flow cytometry before and after treatment in the healthy group and the purpura group (control group and treatment group). The time of remission (regression) of clinical symptoms was recorded in the treatment group and the control group, and the adverse reactions were observed.Results: the clinical effect: the treatment group was significantly better than the control group (P 0.05), there was a significant difference between the two groups. The clinical symptom relief time was shorter in the treatment group than that in the control group.The level of CCR3 in the purpura group was significantly higher than that in the healthy group, and the level of CCR5 was significantly lower than that in the healthy group, and there was a great difference between the two groups. The level of CCR3 in the purpura group was lower than that in the control group before and after treatment, and the level of CCR5 was increased after treatment.The difference between the treatment group and the control group was higher than that in the control group. There were no adverse reactions in the treatment group and after treatment.Conclusion compared with the healthy control group, the level of CCR3 increased and the level of CCR5 decreased in the control group, indicating that there was a predominance expression of Th _ 2 in the patients with HSP, and the level of CCR3 decreased after treatment in the Henoch-Schonlein purpura group, and the difference between the treatment group and the treatment group was significant.
【學(xué)位授予單位】：南昌大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R725.5

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 梁蓉蓉;黃花榮;;CCR5與支氣管哮喘免疫學(xué)發(fā)病機(jī)制研究進(jìn)展[J];新醫(yī)學(xué);2016年01期

2 王學(xué)紅;朱永梅;高來強(qiáng);魏姝s，

本文編號(hào)：1736498