三仁汤合芍药甘草汤加减辨证治疗湿热蕴阻证成人过敏性紫癜疗效及对血清EGF、PAF-AH水平的影响  

Efficacy of Sanren Decoction plus Shaoyao Gancao Decoction on adult Henoch-Schonlein purpura of syndrome of damp-heat accumulation and its effect on serum levels of EGF and PAF-AH

作　　者：师小萌[1] 王月美[1] 边莉[1] 张立欣[1] 白艳秋[1] SHI Xiaomeng;WANG Yuemei;BIAN Li;ZHANG Lixin;BAI Yanqiu(Shijiazhuang Hospital of Traditional Chinese Medicine, Shijiazhuang 050051, Hebei, China)

机构地区：[1]河北省石家庄市中医院,河北石家庄050051

出　　处：《现代中西医结合杂志》2021年第9期949-953,958,共6页Modern Journal of Integrated Traditional Chinese and Western Medicine

基　　金：河北省中医药管理局科研计划项目(2017111)。

摘　　要：目的观察三仁汤合芍药甘草汤加减辨证治疗湿热蕴阻证成人过敏性紫癜性肾炎的临床效果及对患者血清中人表皮生长因子(EGF)、血小板活化因子乙酰水解酶(PAF-AH)水平的影响。方法选择2015年1月—2019年4月石家庄市中医院收治的50例成人过敏性紫癜性肾炎患者为研究对象,随机分为对照组25例和观察组25例。对照组患者给予常规西药治疗,观察组患者给予三仁汤合芍药甘草汤加减,2组均连续治疗4周。观察2组治疗前后主要中医症状积分、肾功能指标及血清中EGF、PAF-AH水平,评价2组临床疗效及用药安全性。结果治疗后,2组患者皮肤紫癜、纳呆呕恶、颜面或下肢水肿、口苦咽干积分和尿红细胞计数(RBC)、24 h尿蛋白定量、尿β_(2)微球蛋白(β_(2)-MG)、尿素氮(BUN)、血肌酐(SCr)、EGF、PAF-AH水平均明显降低(P均<0.05),观察组患者治疗后各指标均显著低于对照组(P均<0.05);观察组有效率为88%(22/25),对照组为64%(16/25),观察组有效率更高(P<0.05);治疗过程中对照组患者不良反应发生率为16%(4/25),观察组为4%(1/25),对照组显著高于观察组(P<0.05)。结论三仁汤合芍药甘草汤加减辨证治疗湿热蕴阻证成人过敏性紫癜性肾炎疗效肯定,利于缓解临床症状,改善肾功能,降低血清中的EGF、PAF-AH水平以减轻肾脏损害,用药安全可靠。Objective It is to observe the clinical effect of Sanren Decoction plus Shaoyao Gancao Decoction in the treatment of adult allergic purpura nephritis with damp-heat accumulation syndrome and its effect on the levels of human epidermal growth factor(EGF)and platelet activating factor acetylhydrolase(PAF)-AH)in serum.Methods Fifty adult patients with Henoch-Schonlein purpura nephritis admitted to Shijiazhuang Hospital of Traditional Chinese Medicine from January 2015 to April 2019 were selected as the research subjects,and they were randomly divided into a control group(n=25)and an observation group(n=25).The patients in the control group were treated with conventional western medicine,and patients in the observation group were treated with modified Sanren Decoction plus Shaoyao Gancao Decoction.Both groups were continuously treated for 4 weeks.The main TCM symptom scores,renal function indexes and the levels of serum EGF and PAF-AH in the two groups were observed before and after treatment,and the clinical efficacy and drug safety of the two groups were evaluated.Results After treatment,the scores of skin purpura,nausea and nausea,facial or lower limb edema,dry mouth and throat and the levels of urine red blood cell count(RBC),24h urine protein quantification,urineβ_(2) microglobulin(β_(2)-MG),blood urea nitrogen(BUN),serum creatinine(SCr),EGF,and PAF-AH were significantly reduced in the patients in both groups(P<0.05),the indicators in the observation group were significantly lower than those in the control group(P<0.05);the effective rate of the observation group was 88.0%(22/25),and that of the control group was 64.0%(16/25),the observation group had a higher effective rate(P<0.05);during the treatment,the incidence of adverse reactions in the control group was 16.0%(4/25),it was 4.0%(1/25)in the observation group,and the control group was significantly higher than the observation group(P<0.05).Conclusion Sanren Decoction plus Shaoyao Gancao Decoction have a definite effect in treating adult allergic purpura

关 键 词：成人过敏性紫癜性肾炎 湿热蕴阻证 三仁汤 芍药甘草汤 人表皮生长因子 血小板活化因子乙酰水解酶 

分 类 号：R554.6[医药卫生—血液循环系统疾病]