目的 探討玉屏風(fēng)顆粒聯(lián)合雙嘧達(dá)莫片治療兒童過(guò)敏性紫癜的臨床療效。方法 選取2020年1月-2022年10月在皖西衛(wèi)生職業(yè)學(xué)院附屬醫(yī)院就診的85例過(guò)敏性紫癜患兒,按照計(jì)算機(jī)隨機(jī)排列法分為對(duì)照組(42例)和治療組(43例)。對(duì)照組口服雙嘧達(dá)莫片,3.0 mg/(kg·d),平均分3次服用。治療組在對(duì)照組基礎(chǔ)上溫水沖服玉屏風(fēng)顆粒,3~8歲,3次/d,半袋/次,8~12歲,3次/d,1袋/次。兩組患兒連續(xù)治療3個(gè)月。觀察兩組臨床療效,比較兩組的主要癥狀消失時(shí)間、可溶性髓樣細(xì)胞表達(dá)觸發(fā)受體樣轉(zhuǎn)錄因子1(TLT1)、白細(xì)胞介素(IL)-9、IL-21、輔助性T細(xì)胞(Th17)、調(diào)節(jié)性T細(xì)胞(Treg)、Th17/Treg水平。結(jié)果 治療后,治療組的總有效率95.35%較對(duì)照組的80.95%更高(P<0.05)。治療后,治療組患兒皮膚紫癲、腹痛、關(guān)節(jié)癥狀、腎臟癥狀消失時(shí)間均短于對(duì)照組(P<0.05)。治療后,兩組的血清TLT1、IL-9水平明顯降低,血清IL-21水平明顯升高(P<0.05);治療后,治療組的血清TLT1、IL-9水平低于對(duì)照組,血清IL-21水平高于對(duì)照組(P<0.05)。治療后,兩組的Th17、Th17/Treg水平低于治療前,Treg水平高于治療前(P<0.05);治療后,治療組的Th17、Th17/Treg水平低于對(duì)照組,Treg水平高于對(duì)照組(P<0.05)。結(jié)論 玉屏風(fēng)顆粒聯(lián)合雙嘧達(dá)莫片可用于兒童過(guò)敏性紫癜,能夠改善臨床癥狀,減輕炎癥反應(yīng),調(diào)節(jié)免疫功能平衡,且藥物安全性良好。

Objective To investigate the clinical effect of Yupingfeng Granules combined with Dipyridamole Tablets e in treatment of children with allergic purpura. Methods Children (85 cases) with allergic purpura in Affiliated Hospital of West Anhui Health Vocational College from January 2020 to October 2022 were divided into the control group (42 cases) and the treatment group (43 cases) according to the computer random arrangement method. Children in the control group were po administered with Dipyridamole Tablets, 3.0 mg/(kg·d), taken in 3 doses. Children in the treatment group were po administered with Yupingfeng Granules on the basis of the control group, 3-8 years old, 0.5 bag/time, three times daily, 8-12 years old, 1 bag/time, three times daily. Children in two groups were treated for 3 months. After treatment, the clinical efficacies were evaluated, and symptom disappearance time, TLT1, IL-9, IL-21, Th17, Treg, and Th17/Treg in two groups were compared. Results After treatment, the total effective rate of 95.35% in the treatment group was higher than 80.95% in the control group (P < 0.05). After treatment, the disappearance time of skin purple epilepsy, abdominal pain, joint symptoms, and kidney symptoms in the treatment group was shorter than that in the control group (P < 0.05). After treatment, the serum levels of TLT1 and IL-9 in two groups were significantly reduced, while the serum levels of IL-21 were significantly increased (P < 0.05). After treatment, the serum levels of TLT1 and IL-9 in the treatment group were lower than those in the control group, while the serum level of IL-21 in the treatment group was higher than those in the control group (P < 0.05). After treatment, the Th17 and Th17/Treg in two groups were lower than before treatment, while the Treg levels in two groups were higher than before treatment (P < 0.05). After treatment, the Th17and Th17/Treg in the treatment group were lower than those in the control group, while the Treg levels in the treatment group were higher than those in the control group (P < 0.05). Conclusion Yupingfeng Granules combined with Dipyridamole Tablets can improve the clinical efficacy of children with allergic purpura, alleviate inflammatory reactions, regulate immune function balance, with good drug safety.

R985

安徽省衛(wèi)生計(jì)生委科研計(jì)劃項(xiàng)目(2016QK082)