【摘要】：目的：通過分析臨床病例，探討糖皮質(zhì)激素治療小兒過敏性紫癜的療效及與中醫(yī)辨證證型的相關性，以期有助于臨床應用。 方法：收集臨床病例，按照臨床實際用藥情況，將病例分為中藥組和中藥加激素組。并對兩組病人進行中醫(yī)辨證，然后采集癥狀體征、證型、用藥、療效等資料，，建立數(shù)據(jù)庫，并運用SPSS17.0統(tǒng)計軟件對兩組患兒的近期療效等進行統(tǒng)計分析，探討其與中醫(yī)證型的相關性。并隨訪1年，以觀察其遠期療效。 結果：1.小兒過敏性紫癜初期以風熱、濕熱等陽熱性證候為主，加用糖皮質(zhì)激素可延長治愈時間，且對風熱傷絡證較濕熱阻絡證影響更為顯著。2.加用糖皮質(zhì)激素可縮短血管神經(jīng)性水腫消失時間，而對皮膚紫癜、腹痛、關節(jié)腫痛消失時間及是否出現(xiàn)腎臟損害、病情反復情況等無顯著影響。3.加用糖皮質(zhì)激素可促使原證型向陽熱、陰虛、郁滯性證候轉(zhuǎn)化。 結論：1.過敏性紫癜治療初期加用糖皮質(zhì)激素可延長病程，且對腎臟損害無預防作用。2.糖皮質(zhì)激素屬辛溫之品，推測其療效有化腎精為氣，動肝氣以升提，行氣祛濕、止癢止痛之功，但可助陽化火擾動心神，因此臨床應合理辨證應用激素，并注意藥物間配伍關系，辨證調(diào)護預防藥源性證。
[Abstract]:Aim: to investigate the therapeutic effect of glucocorticoid on Henoch-Schonlein purpura (Henoch-Schonlein purpura) and its correlation with syndrome differentiation of traditional Chinese medicine (TCM) by analyzing clinical cases. Methods: to collect clinical cases and divide them into two groups according to the clinical situation of drug use: traditional Chinese medicine group and traditional Chinese medicine plus hormone group. Then collect the data of symptoms and signs, syndrome type, drug use, curative effect and so on, establish a database, and use SPSS17.0 statistical software to analyze the short-term curative effect of the two groups of children, and then collect the data of symptoms and signs, syndrome type, drug use, curative effect and so on. To explore the correlation between TCM syndrome type and TCM syndrome type. All patients were followed up for 1 year to observe the long-term effect. Results: 1. In the early stage of Henoch-Schonlein purpura (Henoch-Schonlein purpura), the syndrome of wind-heat, damp-heat and other yang-heat syndrome was dominant. The addition of glucocorticoid could shorten the time of disappearance of vascular and neuroedema, but had no significant effect on skin purpura, abdominal pain, joint swelling and pain, kidney damage or not. 3. The addition of glucocorticoid can promote the transformation of the original syndrome type to yang heat, yin deficiency and stagnation syndrome. Conclusion: 1. The early treatment of Henoch-Schonlein purpura with glucocorticoid can prolong the course of disease and has no preventive effect on renal damage. 2. Glucocorticoid belongs to the product of Xin Wen, and speculates that its curative effect has the function of transforming kidney essence into qi, moving liver qi to lift up, removing qi and dampness, relieving itching and relieving pain, but it can help Yang to turn fire and disturb heart and mind, so the clinical application of hormone should be reasonable according to differentiation of symptoms and signs. And pay attention to the compatibility of drugs, syndrome differentiation of prevention and prevention of drug-derived syndrome.
【學位授予單位】：山東中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2014
【分類號】：R272

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