【摘要】：目的:觀察紫仙丹方治療小兒過(guò)敏性紫癜(血熱妄行證)的臨床療效及治療后尿微量白蛋白、β2-微球蛋白等指標(biāo)的變化情況,分析其能否起到預(yù)防或減輕過(guò)敏性紫癜腎損害的作用。方法:選擇符合納入標(biāo)準(zhǔn)的過(guò)敏性紫癜患兒60例,按隨機(jī)原則分為觀察組30例、對(duì)照組30例。兩組同時(shí)予基礎(chǔ)治療。對(duì)照組患兒予復(fù)方蘆丁40mg/次口服,一天三次;雙嘧達(dá)莫3-5mg/(kg-1·d-1),分2-3次口服。觀察組在對(duì)照組基礎(chǔ)上予紫仙丹方水煎劑,早晚兩次分服。以4周為一個(gè)療程,治療3個(gè)療程。觀察記錄兩組治療前及治療4周、治療8周、治療12周后的臨床癥狀、實(shí)驗(yàn)室觀察指標(biāo)等改善情況,對(duì)比分析兩組治療后的臨床療效及腎損害情況。在治療結(jié)束后進(jìn)行3個(gè)月的隨訪,比較兩組復(fù)發(fā)率,分析兩種治療遠(yuǎn)期療效。結(jié)果:(1)兩組在治療12周后,臨床癥狀改善,中醫(yī)證候總積分均較前降低(p0.05);觀察組證候總積分減少較明顯,與對(duì)照組相比,其差異具有統(tǒng)計(jì)學(xué)意義(p0.05)。(2)兩組在治療8周末、12周末m-Alb水平較同組治療前產(chǎn)生了差異(p0.05),兩組間差異明顯(p0.01),觀察組改善情況優(yōu)于對(duì)照組;而兩組第4周末時(shí)指標(biāo)水平與同組治療前無(wú)統(tǒng)計(jì)學(xué)差異(p0.05),兩組間相比亦無(wú)差異(p0.05)。(3)觀察組治療4周末、8周末、12周末β2-GM水平較前無(wú)明顯波動(dòng),差異無(wú)統(tǒng)計(jì)學(xué)意義(p0.05);對(duì)照組治療4周末、8周末、12周末β2-GM水平較治療前明顯上升,差異均有統(tǒng)計(jì)學(xué)意義(p0.05);不同治療時(shí)點(diǎn)兩組差異具有高度統(tǒng)計(jì)學(xué)意義(p0.01),觀察組優(yōu)于對(duì)照組。(4)兩組在治療4周末、8周末、12周末時(shí)出現(xiàn)的腎損害例數(shù)差異具有統(tǒng)計(jì)學(xué)意義(p0.05),且觀察組腎損例數(shù)明顯少于對(duì)照組。(5)隨訪3月結(jié)束后,觀察組總復(fù)發(fā)率低于對(duì)照組(p0.05)。結(jié)論:(1)中藥紫仙丹方能有效緩解HSP患兒臨床癥狀,在消退皮膚紫癜,緩解腹痛、關(guān)節(jié)痛,改善心煩口渴等情況具有明顯優(yōu)勢(shì),與對(duì)照組相比其療效更確切。(2)紫仙丹方可以有效改善尿微量白蛋白、尿β2-微球蛋白等指標(biāo),與對(duì)照組相比,降低了腎損害發(fā)生率,一定程度上起到了預(yù)防或減輕腎損害的作用。(3)在隨訪中,觀察組復(fù)發(fā)率顯著低于對(duì)照組,故觀察組治療的遠(yuǎn)期效果更理想。(4)口服中藥紫仙丹方治療HSP效果顯著,無(wú)明顯毒副作用,藥物安全可靠,值得臨床應(yīng)用推廣。
[Abstract]:Objective: to observe the clinical effect of Zixiandan recipe in the treatment of allergic purpura in children and the changes of urinary microalbumin and 尾 2-microglobulin after treatment. To analyze whether it can prevent or alleviate the renal damage of Henoch-Schonlein purpura. Methods: 60 children with Henoch-Schonlein purpura were randomly divided into observation group (n = 30) and control group (n = 30). Both groups were treated with basic therapy at the same time. Children in the control group were given compound rutin 40mg/ three times a day and dipyridamole 3-5mg/ (kg-1 d-1) 2-3 times a day. Observation group in the control group on the basis of purple elixir decoction, morning and evening two times. 4 weeks as a course of treatment, 3 courses of treatment. To observe and record the improvement of clinical symptoms, laboratory observation indexes and so on before and after treatment for 4 weeks, 8 weeks and 12 weeks in the two groups, and to compare and analyze the clinical effect and renal damage after treatment in the two groups. Follow up for 3 months after the end of treatment, compare the recurrence rate of the two groups, and analyze the long-term curative effect of the two kinds of treatment. Results: (1) after 12 weeks of treatment, the clinical symptoms of the two groups were improved, the total score of TCM syndromes were all decreased (p0.05), the total score of syndromes in the observation group was significantly decreased than that in the control group, and that in the observation group was significantly lower than that in the control group. The difference was statistically significant (p0.05). (2). The level of m-Alb in the two groups was significantly higher than that in the control group at the end of 8 weeks and 12 weeks after treatment (p0. 05), and the improvement of the observation group was better than that of the control group (p0. 01). However, there was no significant difference between the two groups at the end of the 4th week (p0.05) and between the two groups before treatment (p0.05). (3). There was no significant change in 尾 2-GM level between the two groups at the end of the 4th week and the 12th weekend of the treatment group, and there was no significant difference between the two groups at the end of the 4th week and the 12th weekend after treatment. There was no significant difference (p0. 05), the 尾 2-GM level in the control group was significantly higher than that before treatment at the end of 4 and 8 weeks and 12 weeks after treatment. The difference was statistically significant (p0.05), the difference between the two groups at different time points was highly statistically significant (p0.01), and the observation group was superior to the control group. (4) there were significant differences in the number of cases of renal damage in the two groups at the end of the 4th week and the 8th weekend and the 12th weekend after treatment. The number of renal lesions in the observation group was significantly less than that in the control group. (5) after 3 months of follow-up, the number of renal lesions in the observation group was significantly lower than that in the control group. The total recurrence rate in the observation group was lower than that in the control group (p 0.05). Conclusion: (1) Zixiandan prescription can effectively relieve the clinical symptoms of children with HSP, and has obvious advantages in relieving skin purpura, relieving abdominal pain, joint pain, and improving upset and thirst. Compared with the control group, the curative effect is more accurate. (2) the purple immortal prescription can effectively improve the urinary microalbumin, urine 尾 2-microglobulin and other indexes, compared with the control group, it can reduce the incidence of renal damage. (3) the recurrence rate of the observation group was significantly lower than that of the control group, so the long-term effect of the observation group was better. (4) the effect of the oral Chinese medicine Zixiandan recipe on HSP was significant. There are no obvious side effects and the drugs are safe and reliable, which is worthy of clinical application.
【學(xué)位授予單位】：安徽中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R272

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 黃興;王哲;王保和;;仙鶴草藥理作用及臨床應(yīng)用研究進(jìn)展[J];山東中醫(yī)雜志;2017年02期

2 魏海英;;馬文紅治療過(guò)敏性紫癜經(jīng)驗(yàn)介紹[J];新中醫(yī);2017年01期

3 馬丁妮;潘月麗;;祛濕化斑顆粒治療兒童單純型過(guò)敏性紫癜[J];吉林中醫(yī)藥;2016年11期

4 張妙良;蔡玲玲;張妙瑞;方多多;許開(kāi)拓;林瑋華;楊碧蓮;;從火熱論治過(guò)敏性紫癜經(jīng)驗(yàn)[J];環(huán)球中醫(yī)藥;2016年11期

5 李菁華;吳衛(wèi)東;楊莉;;霉酚酸酯治療過(guò)敏性紫癜腎炎的療效與安全性[J];當(dāng)代醫(yī)學(xué);2016年29期

6 夏利平;陳旭;姜毅;;丙種球蛋白沖擊治療兒童腹型過(guò)敏性紫癜療效觀察[J];中國(guó)當(dāng)代兒科雜志;2016年10期

7 李琳;;中西醫(yī)結(jié)合治療過(guò)敏性紫癜的臨床研究[J];光明中醫(yī);2016年16期

8 高健;;218例過(guò)敏性紫癜患兒食物不耐受檢測(cè)結(jié)果及分析[J];安徽衛(wèi)生職業(yè)技術(shù)學(xué)院學(xué)報(bào);2016年04期

9 孫瑩瑩;吳文先;李露萍;黃巖杰;劉霞;;從“熱毒作祟致瘀”探析劉霞治療小兒過(guò)敏性紫癜經(jīng)驗(yàn)[J];北京中醫(yī)藥;2016年08期

10 鄧美慧;苗靜;鄭衛(wèi)民;傅睿;黃玉輝;;過(guò)敏性紫癜患兒血清IL-6、IL-8、IL-10、NTF-α及IgA表達(dá)的意義[J];江西醫(yī)藥;2016年08期

相關(guān)碩士學(xué)位論文 前7條

1 宋曉明;注射用丹參聯(lián)合涼血化斑湯治療過(guò)敏性紫癜的臨床療效觀察[D];山東中醫(yī)藥大學(xué);2015年

2 王玲玲;紫草清癜湯加減治療過(guò)敏性紫癜的臨床療效觀察[D];山西省中醫(yī)藥研究院;2015年

3 郭X;加味犀角地黃湯聯(lián)合西藥治療小兒過(guò)敏性紫癜（血熱妄行證）的臨床療效觀察[D];甘肅中醫(yī)藥大學(xué)(原名：甘肅中醫(yī)學(xué)院);2015年

4 張敏;小兒過(guò)敏性紫癜急性期外周血CD4~+、CD8~+T細(xì)胞及免疫球蛋白的變化及意義[D];大連醫(yī)科大學(xué);2014年

5 李娟;兒童過(guò)敏性紫癜基因表達(dá)譜及腎損傷相關(guān)基因研究[D];南昌大學(xué);2012年

6 胡玲;消腫化斑湯外敷治療小兒過(guò)敏性紫癜關(guān)節(jié)型的臨床療效觀察[D];長(zhǎng)春中醫(yī)藥大學(xué);2012年

7 曲筱靜;藕節(jié)促凝血活性物質(zhì)的篩選及其作用機(jī)制的初步研究[D];江南大學(xué);2008年

，

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