CAJ | 학술논문

目的观察活血凉血化瘀法防治过敏性紫癜(HSP)肾损害的临床疗效.方法通过随机、盲法、对照的试验设计,研究50名过敏性紫癜患儿,随机分为治疗组和对照组,对照组给予潘生丁等治疗,治疗组在对照组基础上加用活血凉血中药复方,定期观察尿微量蛋白和T细胞亚群、血D二聚体、循环免疫复合物、血清超氧化物歧化酶和丙二醛等的变化.结果 ①β_2-微球蛋白(β_2-M)治疗后两组比较差异有统计学意义.微量白蛋白(Alb)治疗后2,4个月两组比较差异无统计学意义,治疗后6个月两组比较差异有统计学意义.②治疗后两组总体疗效比较差异无显著性意义,并均无不良反应发生.③两组治疗前后D二聚体、循环免疫复合物,差异无统计学意义.④两组治疗前CD_4/CD_8,SOD和MDA,差异无统计学意义,两组治疗后CD_4/CD_8,SOD和MDA,差异有统计学意义.两组各治疗前后ALb、β_2-M,差异有统计学意义.两组各治疗前后血T细胞亚群(CD_4/CD_8),差异有统计学意义,治疗组丙二醛治疗前后,差异有统计学意义(P<0.001),对照组治疗前后血丙二醛差异无统计学意义(P=0.193).两组各治疗前后血清超氧化物歧化酶,差异有统计学意义(P<0.001).结论活血凉血化瘀法对HSP有较好疗效,能减少尿微量蛋白的排泄,减少HSP肾损害的发生.作用机理可能与其调节T细胞免疫功能紊乱,及清除氧自由基对机体的损伤有关.HSP属于免疫复合物(CIC)介导的免疫性疾病,两组治疗前后D二聚体、循环免疫复合物差异无统计学意义,可能与研究的样本例数偏小有关.
목적 관찰활혈량혈화어법방치과민성자전(HSP)신손해적림상료효.방법 통과수궤、맹법、대조적시험설계,연구50명과민성자전환인,수궤분위치료조화대조조,대조조급여반생정등치료,치료조재대조조기출상가용활혈량혈중약복방,정기관찰뇨미량단백화T세포아군、혈D이취체、순배면역복합물、혈청초양화물기화매화병이철등적변화.결과 ①β_2-미구단백(β_2-M)치료후량조비교차이유통계학의의.미량백단백(Alb)치료후2,4개월량조비교차이무통계학의의,치료후6개월량조비교차이유통계학의의.②치료후량조총체료효비교차이무현저성의의,병균무불량반응발생.③량조치료전후D이취체、순배면역복합물,차이무통계학의의.④량조치료전CD_4/CD_8,SOD화MDA,차이무통계학의의,량조치료후CD_4/CD_8,SOD화MDA,차이유통계학의의.량조각치료전후ALb、β_2-M,차이유통계학의의.량조각치료전후혈T세포아군(CD_4/CD_8),차이유통계학의의,치료조병이철치료전후,차이유통계학의의(P<0.001),대조조치료전후혈병이철차이무통계학의의(P=0.193).량조각치료전후혈청초양화물기화매,차이유통계학의의(P<0.001).결론 활혈량혈화어법대HSP유교호료효,능감소뇨미량단백적배설,감소HSP신손해적발생.작용궤리가능여기조절T세포면역공능문란,급청제양자유기대궤체적손상유관.HSP속우면역복합물(CIC)개도적면역성질병,량조치료전후D이취체、순배면역복합물차이무통계학의의,가능여연구적양본례수편소유관.
Objective To observe the LiangXueHuoXueHuaYu decoction's clinical curative effect in the prevention and therapy on the kidney injury caused by anaphylactoid purpura.Methods Through randomized,blinding,control design of experiment, we researched 50 HSP sufferers. They were randomly divided into treatment and control group. In control group they were given the Persantinum only. In treatment group they were given both the Persantinum and LiangXueHuoXueHuaYu decoction. We observed the change of the urine β_2-microglobulin,the output of proteinuria in 24H,T lymphocytes subgroup,blood D-dimer,circulate immunocomplex(CIC), serum superoxide dismutase orgotein(SOD) and malonaldehyde(MDA) periodically.Results (1) After therapy, the β_2-microglobulin had statistical difference in the two group. There was no significant difference for Alb between this two groups after 2, 4 months' therapy, but it was significantly different after 6-month therapy.(2) There was no significant difference in curative effect, and adverse drug reaction didn't occur in both of them.(3) There was no significant difference for D-dimer and CIC in these two groups before and after therapy.(4) There was no significant difference for CD_4/ CD_8,SOD and MDA in this two groups before therapy, but it significantly different after therapy. After therapy, Alb、β_2-M and CD_4/CD_8 had significant statistical difference compared with those before therapy in each group. After therapy, MDA had significant statistical difference compared with that before therapy in treatment group (P<0.001),but it had no significant statistical difference in control group(P=0.193). There is no significant difference by SOD in this two group before and after therapy(P<0.001).Conclusion LiangXueHuoXueHuaYu decoction has good clinical therapentic effect in HSP. It can reduce the excretion of the urine β_2-microglobulin, reduce the occurrence of the injury of kidney. Its mechanism may be relative to the regulation of the disorder of T-cell's immunity function and the elimination of oxygen free redicals. The HSP belongs to the immunity disease that mediated by the CIC, but after therapy, D-dimer and CIC have no significant statistical difference compared with those before therapy in each group. It may be relative to the deficient of sample size.