丹参地黄汤对小儿过敏性紫癜肾炎的早期治疗作用

目的观察丹参地黄汤对小儿过敏性紫癜肾炎早期治疗作用。方法将60例小儿过敏性紫癜肾炎患儿随机分成对照组和观察组各30例,两组均给予降低血管通透性、抗过敏、抑制血小板聚集药物基础治疗。对照组给予泼尼松0.5mg/(kg.d)晨顿服,病情稳定后递减至维持量,疗程8周。第1周同时给予西咪替丁10mg/(kg.d),分2次静脉滴注;第2周改为5mg/(kg.d),分2次口服;维持治疗至第3周末停药。观察组口服丹参地黄汤,每日2次,每次50～100ml。两组治疗疗程均为8周。观察两组肾脏损害发生率、肾脏损害开始发生时间及治疗前后尿蛋白、尿红细胞水平、凝血酶原时间、纤维蛋白原、血清免疫球蛋白的含量。结果治疗8周后,观察组肾脏损害发生率显著低于对照组(P<0.05),肾脏损害开始发生的时间显著晚于对照组(P<0.01);观察组尿红细胞、尿蛋白较治疗前显著减少(P均<0.01),并显著少于对照组(P<0.01);观察组FIB含量显著下降(P<0.01),而PT则显著延长(P<0.01),两指标与对照组比较差异有统计学意义(P<0.01);观察组血清IgA、IgM、IgE水平及对照组血清IgM、IgE水平均有不同程度下降(P<0.01);且观察组IgA、IgM下降幅度较对照组更为明显(P<0.05或0.01)。结论丹参地黄汤可有效减少过敏性紫癜发生肾脏损害几率,对过敏性紫癜肾炎有早期预防作用。

Effect of DanShen and DiHuang Decoction on early treatment of pediatric anaphylactoid purpura nephritis

Objective To observe the effect of DanShen and DiHuang Decoction on early treatment of pediatric anaphylactoid purpura nephritis.Methods 60 children with anaphylactoid purpura nephritis were randomly divided into the control group and the experimental group with 30 patients in each group.Both groups were given basic treatment with the drugs for reducing the vascular permeability,resisting anaphylaxis and inhibiting platelet aggregation.The control group took 0.5 mg/(kg·d) of prednisone once in early morning,which was descended to the maintenance dose for 8 weeks after the patient’condition was stable.In the 1st week,10 mg/(kg·d)of cimetidine was simultaneously given twice by intravenous drip;in the 2nd week,5 mg/(kg·d) of cimetidine was 2 orally administered twice until the 3rd week.The experimental group orally administer 50~100 ml of DanShen and DiHuang Decoction twice every day.The course of treatment for both groups was 8 weeks.The incidence and onset time of renal damage,urine protein,red blood cell count in urine,prothrombin time,fibrinogen and serum immunoglobulin content were observed before and after treatment.Results After treatment for 8 weeks,the incidence of renal damage in the experimental group was significantly lower than that of the control group(P<0.05).And the onset time of renal damage for theexperimental group was later than that of the control group(P<0.01).For the experimental group,the urine protein,red blood cell in urine reduced significantly(P<0.01) and the PT was longer(P<0.01).Compared to the control group,there was statistical differences in the two indexes.The serum IgA,IgM,IgE in the experimental group and IgA,IgM in the control group were lower than those before treatment(P<0.01).And the IgA,IgM of the experimental group had more significant descending level(P<0.05 or 0.01). Conclusion The DanShen and DiHuang Decoction can effectively reduce the incidence of renal damage for patients with anaphylactoid purpura,and has the effect of early prevention against anaphylactoid purpura nephritis.