雷公藤总苷治疗儿童难治性皮肤紫癜的疗效  

Effect of Tripterygium Wilfordii Polyglycoside on Treating Refractory Skin Purpura in Children

作　　者：丁立[1] 陈浩[1] 张芝艳 黄荧[1] 

机构地区：[1]常州市儿童医院儿科,江苏常州213000

出　　处：《实用儿科临床杂志》2010年第21期1651-1653,共3页Journal of Applied Clinical Pediatrics

摘　　要：目的观察雷公藤总苷(TWP)治疗儿童过敏性紫癜(HSP)难治性皮肤紫癜的疗效,同时观察TWP预防HSP肾损害的作用。方法 67例单纯性皮肤紫癜患儿经一般治疗2周后皮疹仍反复发作,且无肾损伤患儿随机分为泼尼松治疗组32例(泼尼松1 mg.kg-1.d-1,最大量不超过60 mg.d-1,疗程2周),TWP治疗组35例(TWP1 mg.kg-1.d-1,最大量不超过45 mg.d-1,疗程2周),观察2组患儿疗效、HSP并发症发生情况及TWP的不良反应。结果 1.治疗疗效:泼尼松治疗组皮疹治疗有效率62.50%,紫癜消退时间(8.13±2.12)d;TWP治疗组有效率85.71%,紫癜消退时间(5.63±1.97)d,2组有效率及紫癜消退时间比较差异均有统计学意义(χ2=4.758、t=5.003,Pa<0.05)。治疗后,泼尼松治疗组患儿皮疹复发次数为(4.32±1.68)次,TWP治疗组皮疹复发次数为(3.01±2.14)次,2组比较差异有统计学意义(t=2.769,P<0.05)。2.并发症和不良反应:泼尼松治疗组患儿肾损害发生率为18.75%,消化道及关节症状发生率分别为46.88%、34.38%;TWP治疗组患儿肾损害发生率为14.29%,消化道及关节症状发生率分别为28.57%、17.14%,2组比较差异均无统计学意义(Pa>0.05)。随访期间,TWP治疗患儿血常规及肝肾功能无异常。结论 TWP治疗儿童HSP难治性皮肤紫癜疗效优于糖皮质激素。TWP短程治疗具有早期预防HSP肾损害的作用,且无明显不良反应。Objective To explore the effect of tripterygium wilfordii polyglycoside（TWP） on treating refractory skin purpura in children and in preventing the renal damage from Henoch-Schonlein purpura（HSP）.Methods Sixty-seven cases of children with simple HSP,whose skin purpura continued to recur in spite of general treatment for 2 weeks and had no renal damage,were divided into 2 groups randomly.One was steroid group（n=32）,receiving steroid therapy（prednisone 1 mg·kg^-1.d^-1,maximum dose60 mg·d^-1,for 2 weeks）.Another was tripterygium group（n=35）,receiving TWP therapy（TWP 1 mg·kg^-1.d^-1,maximum dose45 mg·d^-1,for 2 weeks）.Then the treatment effect and the rate of HSP complications of the 2 groups were compared.The side effect of TWP was explored at the same time.Results 1.The treatment effect for skin purpura： The effective rate of steroid group was 62.50%,while tripterygium group was 85.71%（χ^2=4.758,P〈0.05）.The mean regression time of skin purpura of steroid group was（8.13±2.12） d,while tripterygium group was（5.63±1.97） d（t=5.003,P〈0.05）.After therapy,the mean number of times of skin purpura recurrence in steroid group was（4.32±1.68） times,while tripterygium group was（3.01±2.14） times（t=2.769,P〈0.05）.2.The complications and the side effect of TWP： The rate of renal damage,enteron and joints symptoms in steroid group were 18.75%,46.88% and 34.38%,respectively,while tripterygium group were 14.29%,28.57% and 17.14%,respectively.Significant differences were not found between the 2 groups（Pa〉0.05）.Routine blood tests,liver and kidney function for patients who received TWP were normal.Conclusions TWP is effective in treating refractory skin purpura in children with HSP.And it is better than steroid therapy.And the short therapy of TWP is also effective in preventing renal damage from HSP,and it has no obvious side effect.

关 键 词：雷公藤总苷 过敏性紫癜 皮肤紫癜 肾损害 

分 类 号：R725.5[医药卫生—儿科]