过敏性紫癜甲襞微循环和外周血T细胞亚群的变化及中药加糖皮质激素治疗的疗效观察

目的：探讨过敏性紫癜（ＨＳＰ）患儿微循环与Ｔ细胞亚群的改变及中西医结合治疗的疗效。方法：对４０例ＨＳＰ患儿进行甲襞微循环与Ｔ细胞亚群变化的观测；随机分为清热凉血、活血化瘀加激素治疗组（２０例）和激素治疗对照组（２０例），对比２组疗效，另设２４例正常儿童Ｔ细胞亚群对照观察。结果：ＨＳＰ患儿ＣＤ＋３、ＣＤ＋４百分率及ＣＤ＋４／ＣＤ＋８比值均低于正常对照组（Ｐ均＜０．０１）。治疗组治愈率较治疗对照组明显升高分别为１００％与９０％，Ｐ＜０．０１；皮疹复发率（１５％）和紫癜肾炎发生率（１５％）均显著低于治疗对照组（５０％和５５％），Ｐ均＜０．０５。结论：ＨＳＰ存在甲襞微循环与Ｔ细胞亚群异常改变；用清热凉血、活血化瘀中药加激素联合治疗较单纯激素治疗更为有效、安全。

The changes in nailfold microcirculation and T cell subgroup in anaphylactoid purpura and observation on curative effects in treatment with integrated traditional Chinese and western medicine

Objective :To investigate the changes in microcirculation and T cell subgroup in anaphylactoid purpura and curative effects on it with integrated traditional Chinese (TCM) and western medicine (WM). Methods :40 children suffering from anaphylactoid purpura were randomly divided into two groups,the treatment group n=20,clear heat and cool the blood (),promote blood circulation and remove blood stasis () plus steroid and the control group (n=20,steroid).The nailfold microcirculation and T cell subgroup were observed meanwhile the curative effects were compared between two groups. Results :The CD 3,CD 4 and CD 4/CD 8 ratio in ill children with anaphylactoid purpura were obviously lower than those in control group (all P<001) meanwhile the cured rate in treatment group was significantly higher than that in control group (100% vs.90%,P<001).The rates of rash relapse and purpuric nephritis occurance in treatment group were significantly lower than those in control group (both P<005). Conclusions :The abnormal changes in nailfold microcirculation and T cell subgroup in anaphylactoid purpura are existed.The treatment with decoctions of clear heat and cool the blood,promote blood circulation and remove blood stasis,and adding steroid is much more effective and safer than that with steroid alone.