犀角地黄汤加味对过敏性紫癜(血热妄行型)患者血清GPⅡb/Ⅲa表达影响临床观察  

Clinical Observation of Modified Xijiao Dihuang Decoction(犀角地黄汤)for Henoch-Schonlei Purpura(Blood Heat Extravasation type)Serum GPⅡb/Ⅲa Expression

作　　者：宋纯东[1] 宋丹 花淑婷 丁樱[2] 任献青[2] 张霞[1] 杨濛[1] 张建[2] 翟文生[2] SONG Chundong;SONG Dan;HUA Shuting;DING Ying;REN Xianqing;ZHANG Xia;YANG Meng;ZHANG Jian;ZHAI Wensheng(The First Affiliated Hospital of Henan University of Chinese Medicine,Zhengzhou 450008,Henan,China;Henan University of Chinese Medicine,Zhengzhou 450046,Henan,China;Jiaozuo Second People's Hospital,Jiaozuo 454150,Henan,China)

机构地区：[1]河南中医药大学第一附属医院,河南郑州450008 [2]河南中医药大学,河南郑州450046 [3]焦作市第二人民医院,河南焦作454150

出　　处：《辽宁中医药大学学报》2022年第1期4-8,共5页Journal of Liaoning University of Traditional Chinese Medicine

基　　金：河南省科技攻关重点项目(202102310494);河南省中医管理局国家中医临床研究基地科研专项重点课题(2018JDZX119);河南省中医药管理局科技攻关普通项目(2018JDZX017)。

摘　　要：目的观察犀角地黄汤加味对过敏性紫癜(血热妄行型)患者血清血小板膜糖蛋白(glycoproteinⅡb/Ⅲa,GPⅡb/Ⅲa)表达水平的影响及与肾脏保护的相关性。方法选取90例过敏性紫癜(Henoch-Schonlein purpura,HSP)血热妄行型患者,采用随机数字表法分为治疗组45例,对照组45例。对照组予以西医常规治疗,治疗组给予犀角地黄汤加味。两组患者均于治疗前及治疗8周后检测血常规、尿常规,记录尿红细胞计数、尿白蛋白/肌酐水平、血小板(platelet,PLT)计数,采用酶联免疫吸附测定法(enzyme-linked immuno sorbent assay,ELISA)检测患者血清GPⅡb/Ⅲa的表达水平。结果治疗后,治疗组总有效率(93.33%)高于对照组(73.33%),P<0.05,差异有统计学意义;两组均能改善紫癜分布、形态及颜色,治疗组优于对照组(P<0.05)。治疗组出现肾损伤3例(6.7%),对照组出现13例(28.9%),P<0.05。治疗后,治疗组尿红细胞计数、尿白蛋白/肌酐水平、PLT计数及患者血清GPⅡb/Ⅲa表达量均较对照组明显降低(P<0.05),经Pearson相关性分析,尿白蛋白/肌酐水平降低与血清GPⅡb/Ⅲa表达水平呈正相关。结论犀角地黄汤加味能有效减轻血热妄行型HSP患者临床症状及肾损伤的比例,降低尿白蛋白/肌酐水平、血小板计数及GPⅡb/Ⅲa表达量,且GPⅡb/Ⅲa表达量与尿白蛋白/肌酐水平呈正相关。Objective To observe the effect of Modified Xijiao Dihuang Decoction(犀角地黄汤)on the expression of platelet membrane glycoproteinⅡb/Ⅲa(GPⅡb/Ⅲa)in the serum of patients with Henoch Schonlein purpura(HSP)and its correlation with renal protection.Methods 90 patients with HSP were randomly divided into treatment group(45 cases)and control group(45 cases).The control group was treated with Western medicine,and the treatment group was given Xijiao Dihuang Decoction.Blood routine test,urine routine test,urine red blood cell count,urine albumin/creatinine,platelet(PLT)count were measured before and 8 weeks after treatment in both groups,and the expression of GPⅡb/Ⅲa in serum was measured by enzyme-linked immunosorbent assay(ELISA).Results After treatment,the total effective rate of the treatment group was 93.33%,the control group was 73.33%(P<0.05),the difference was statistically significant;the distribution,shape and color of purpura were improved in both groups,and the treatment group was better than the control group(P<0.05).There were 3 cases(6.7%)of renal injury in the treatment group and 13 cases(28.9%)in the control group,P<0.05.After treatment,the expression of urine RBC,urine albumin/creatinine,PLT and GPⅡb/Ⅲa in the treatment group were significantly lower than that in the control group(P<0.05).According to Pearson correlation analysis,the decrease of urine albumin/creatinine was positively correlated with the expression of GPⅡb/Ⅲa in the serum.Conclusion Xijiao Dihuang Decoction can effectively reduce the clinical symptoms and renal injury rate of HSP patients with blood heat,reduce the urinary albumin/creatinine,platelet count and GPⅡb/Ⅲa expression,and the latter is positively related to the reduction of urinary albumin/creatinine.

关 键 词：过敏性紫癜 犀角地黄汤 尿白蛋白 肌酐水平 血清血小板膜糖蛋白 临床观察 

分 类 号：R554.6[医药卫生—血液循环系统疾病]