凉血调免方联合西医治疗儿童过敏性紫癜的疗效及对Th17/Treg失衡的作用  

Effect of Liangxuetiaomian Decoction Combined with Western Medicine in the Treatment of Children Anaphylactoid Purpura and Its Impact on Th17/Treg Imbalance

作　　者：许恩超[1] 傅睿[1] 刘志强[1] 周顺龙[1] 卢宏昌[1] 李荣珍[1] 

机构地区：[1]江西省儿童医院,江西南昌330006

出　　处：《现代诊断与治疗》2018年第8期1180-1184,共5页Modern Diagnosis and Treatment

摘　　要：目的观察凉血调免方联合西医常规疗法治疗儿童过敏性紫癜(HSP)的临床疗效及对患儿Th17/Treg的影响。方法将58例初治蛋白尿阴性HSP患儿随机分为西医组和调免组各29例。西医组采用西医常规治疗;调免组在西医组基础上加用凉血调免方治疗。同时选择30例健康儿童作为健康组。观察治疗前后症状、体征,尿常规,Treg、IL-17变化及治疗后的复发情况。结果调免组治疗有效率为96.55%,西医组为72.41%,差异具有统计学意义;调免组皮疹消退时间显著短于西医组,差异具有统计学意义;调免组复发率为10.34%,西医组为41.38%,差异具有统计学意义;调免组肾损害率为3.45%,西医组为10.34%,两组损害率比较无显著性差异;治疗前两组患儿Treg均较健康组低,IL-17均较健康组高,差异具有统计学意义;调免组治疗后Treg较治疗前升高,差异有统计学意义,与健康组比较无显著性差异;西医组Treg治疗前后比较差异无统计学意义;治疗后两组患儿IL-17均显著降低,调免组IL-17降低更明显,差异有统计学意义与健康组比较无显著性差异。结论凉血调免方联合西医常规疗法治疗儿童过敏性紫癜的有效率优于单纯西医常规治疗,可明显减少复发,缩短皮疹消退时间,但不能明显减少HSP患儿的肾损害发生率。过敏性紫癜患儿急性期存在IL-17水平的升高和Treg细胞比例的降低,即Th17/Treg功能平衡紊乱,凉血调免方对HSP患儿Th17/Treg失衡有调节作用。Objective To observe the clinical effect of Liangxue Tiaomian Decoction combined with western medicine in the treatment of children with Anaphylactoid Purpura and its effect on Th17/Treg in children.Method 58 children with initial urine protein-negative HSP were randomly divided into 2 groups:Western medicine group(29)and transfer group(29).The western medicine group was treated with western medicine routine treatment,while the regulating and exemption group was treated with Liangxue Tiaomian Decoction on the basis of Western medicine group.At the same time,30 healthy children were selected as the health group.The symptoms,signs,urine routine,Treg,IL-17 and recurrence after treatment were observed.Results The effective rate of the treatment group was 96.55%,the western medicine group was 72.41%,the difference was significant(P<0.05),the time of the exempting group rash was significantly shorter than that in the western medicine group(P<0.01),the recurrence rate of the exempting group was 10.34%,the western medicine group was 41.38%,the difference was significant(P<0.01),the rate of renal damage in the exempting group was 3.45%and the western medicine group was 10.34%,The difference was not statistically significant(P>0.05);the two groups before the treatment were lower than the healthy group,and the IL-17 was higher than the healthy group(P<0.05).The difference was statistically significant(P<0.01)after the treatment(P<0.01),and there was no statistical significance(P>0.05)compared with the healthy group(P>0.05).The western medicine group was treated with Treg treatment.There was no statistical difference before and after treatment(P>0.05),and IL-17 decreased significantly in the two groups after treatment(P<0.01),and the decrease of IL-17 in the exempting group was more obvious than that in the western medicine group(P<0.05),and there was no statistical difference compared with the healthy group(P>0.05).Conclusion The effective rate of treating children with anaphylactoid purpura was better than that of simple w

关 键 词：凉血调免方 过敏性紫癜 TREG IL-17 

分 类 号：R725.5[医药卫生—儿科]