甲泼尼龙冲击疗法联合凉血消斑汤熏洗治疗儿童过敏性紫癜的临床效果  

Clinical efficacy of methylprednisolone pulse therapy combined with Liangxue Xiaoban decoction for the treatment of children with Henoch-schonlein purpura(HSP)

作　　者：刘道路 郭轲 张瑜 魏闪 LIU Daolu;GUO Ke;ZHANG Yu;WEI Shan(Department of Pediatrics,Affiliated Hospital of Huaibei Vocational and Technical College,Huaibei Anhui 235100,China)

机构地区：[1]淮北职业技术学院附属医院儿科,安徽淮北235100

出　　处：《新疆医科大学学报》2025年第4期538-543,共6页Journal of Xinjiang Medical University

基　　金：安徽省高等学校自然科学技术研究项目(2023AH052148)。

摘　　要：目的探讨甲泼尼龙冲击疗法联合凉血消斑汤熏洗在儿童过敏性紫癜(HSP)中的疗效。方法选择淮北职业技术学院附属医院儿科2020年3月至2024年2月收治的HSP患儿80例为研究对象,采用随机数字表法分组,各40例。常规治疗基础上,对照组给予甲泼尼龙冲击疗法,治疗组给予甲泼尼龙冲击疗法联合凉血消斑汤熏洗。比较两组治疗总有效率、症状消退时间、安全性及中医证候积分、免疫球蛋白、炎症因子水平,随访6个月统计复发率。结果治疗组总有效率(95.00%)高于对照组(77.50%)(P<0.05)。与治疗前比较,治疗后两组中医证候积分、血清IgA、IgE、IgM水平及血清TNF-α、IL-6、IL-8水平降低,且治疗组低于对照组(P<0.05)。治疗组症状消退时间短于对照组(P<0.05)。对照组2例不良反应,治疗组1例不良反应,差异无统计学意义(P>0.05)。治疗组复发率(3.70%)低于对照组(23.53%)(P<0.05)。结论甲泼尼龙冲击疗法联合凉血消斑汤熏洗可缩短HSP症状消退时间,降低免疫球蛋白水平、炎症因子水平与复发率,临床疗效优于单一甲泼尼龙治疗。Objective To investigate the efficacy of methylprednisolone pulse therapy combined with Liangxue Xiaoban decoction for the treatment of children with Henoch-schonlein purpura(HSP).Methods 80 children with HSP from March 2020 to February 2024 at the hospital were selected and randomly divided into groups of 40 each using a random number table method.On the basis of conventional treatment,the control group received methylprednisolone shock therapy,while the treatment group received methylprednisolone shock therapy combined with Liangxue Xiaoban decoction fumigation and washing.Compare the total effective rate,symptom resolution time,safety,traditional Chinese medicine(TCM)syndrome score,immunoglobulin and inflammatory factor levels between the 2 treatment groups,and follow up for 6 months to calculate the recurrence rate.Results The total effective rate of the treatment group(95.00%)was higher than that of the control group(77.50%)(P<0.05).Compared with before thetreatment,the TCM syndrome scores,serum IgA,IgE,IgM levels,and serum TNF-α,IL-6,IL-8 levels in both groups was decreased after the treatment,and the treatment group was lower than the control group(P<0.05).The symptom resolution time of the treatment group was shorter than that of the control group(P<0.05).There were 2 adverse reactions in the control group and 1 adverse reaction in the treatment group,and the difference was not statistically significant(P>0.05).The recurrence rate of the treatment group(3.70%)was lower than that of the control group(23.53%)(P<0.05).Conclusion The combination of methylprednisolone shock therapy and Liangxue Xiaoban decoction fumigation can shorten the time for HSP symptoms to subside,reduce immunoglobulin levels,inflammatory factor levels,and recurrence rates.The clinical efficacy is superior to that of single methylprednisolone treatment.

关 键 词：儿童过敏性紫癜 甲泼尼龙 中药熏洗 凉血消斑汤 免疫球蛋白 炎症因子 

分 类 号：R725.5[医药卫生—儿科]