自拟清热凉血解毒方辅助治疗小儿过敏性紫癜性肾炎湿毒内蕴型的临床疗效和对凝血机制的影响
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摘要
目的观察自拟清热凉血解毒方辅助治疗对小儿过敏性紫癜性肾炎湿毒内蕴型的临床疗效和凝血机制的影响。方法选取2017年4月至2018年6月过敏性紫癜性肾炎湿毒内蕴型患儿76例,随机分为对照组和治疗组,各38例。对照组给予常规西药对症治疗,如口服激素及抗凝药物。治疗组在对照组治疗方法的基础上给予口服自拟清热凉血解毒方治疗,每日1剂,早晚分服。2组均连续治疗2周后,观察临床疗效、临床症状消失时间和治疗前后凝血指标的变化。结果治疗组总有效率为94.74%,高于对照组的78.95%,2组比较,差异有统计学意义(P<0.05)。治疗后,治疗组的皮肤紫癜、腹痛、便血消失时间均短于对照组,2组比较,差异均有统计学意义(P<0.05)。与同组治疗前比较,2组治疗后D-二聚体、抗凝血酶、凝血酶时间、凝血酶原时间、活化部分凝血活酶时间、纤维蛋白原、血小板指标均有所改善(P<0.05),且治疗组明显优于对照组,差异均有统计学意义(P<0.05)。结论自拟清热凉血解毒方辅助治疗过敏性紫癜性肾炎湿毒内蕴型患儿临床疗效满意,可显著缩短临床症状消失时间,有效改善凝血情况,值得临床推广应用。
Objective To observe the effect on clinical efficacy and clotting mechanism of self-made Qingre Liangxue Jiedu Fang(清热凉血解毒方) in the adjuvant treatment of nephritis of Schonlein-Henoch purpura with retention of noxious dampness in the interior type in children.Methods Seventy-six cases of nephritis of Schonlein-Henoch purpura in children with retention of noxious dampness in the interior type from April 2017 to June 2018 were randomly divided into control group and treatment group,with 38 cases in each.The control group was given symptomatic treatment of routine Western medicine,such as oral hormones and anticoagulant drugs.The treatment group was given oral self-made Qingre Liangxue Jiedu Fang on the basis of the control group, 1 dose a day, took it separately in the morning and evening.After consecutive treatment for 2 weeks,the clinical efficacy,the disappearance time of clinical symptoms and coagulation index before and after treatment were compared.Results The total effective rate of the treatment group was 94.74%,which was higher than 78.95% of the control group,and there was statistically significant difference between the two groups(P<0.05).After treatment,the disappearance time of skin purpura,abdominal pain and hemafecia in the treatment group were shorter than those of the control group, and there were statistically significant differences between the two groups(P<0.05).Compared with the same group before treatment,D-Dimer,antithrombin, thrombin time,prothrombin time, activated partial thromboplastin time,fibrinogen,platelet index all improved to some extent in the two groups after treatment(P<0.05),moreover,these of the treatment group were significantly superior to those of the control group,the differences were statistically significant(P<0.05).Conclusion It has satisfactory clinical efficacy to use self-made Qingre Liangxue Jiedu Fang in the adjuvant treatment of nephritis of Schonlein-Henoch purpura with retention of noxious dampness in the interior type in children.It not only significantly shortens the disappearance time of clinical symptoms,but also effectively improves the coagulation,which deserves clinical promotion and application.
Objective To observe the effect on clinical efficacy and clotting mechanism of self-made Qingre Liangxue Jiedu Fang(清热凉血解毒方) in the adjuvant treatment of nephritis of Schonlein-Henoch purpura with retention of noxious dampness in the interior type in children.Methods Seventy-six cases of nephritis of Schonlein-Henoch purpura in children with retention of noxious dampness in the interior type from April 2017 to June 2018 were randomly divided into control group and treatment group,with 38 cases in each.The control group was given symptomatic treatment of routine Western medicine,such as oral hormones and anticoagulant drugs.The treatment group was given oral self-made Qingre Liangxue Jiedu Fang on the basis of the control group, 1 dose a day, took it separately in the morning and evening.After consecutive treatment for 2 weeks,the clinical efficacy,the disappearance time of clinical symptoms and coagulation index before and after treatment were compared.Results The total effective rate of the treatment group was 94.74%,which was higher than 78.95% of the control group,and there was statistically significant difference between the two groups(P<0.05).After treatment,the disappearance time of skin purpura,abdominal pain and hemafecia in the treatment group were shorter than those of the control group, and there were statistically significant differences between the two groups(P<0.05).Compared with the same group before treatment,D-Dimer,antithrombin, thrombin time,prothrombin time, activated partial thromboplastin time,fibrinogen,platelet index all improved to some extent in the two groups after treatment(P<0.05),moreover,these of the treatment group were significantly superior to those of the control group,the differences were statistically significant(P<0.05).Conclusion It has satisfactory clinical efficacy to use self-made Qingre Liangxue Jiedu Fang in the adjuvant treatment of nephritis of Schonlein-Henoch purpura with retention of noxious dampness in the interior type in children.It not only significantly shortens the disappearance time of clinical symptoms,but also effectively improves the coagulation,which deserves clinical promotion and application.
引文
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[5]王凤英, 李晓忠, 王兴东,等. 肾小球内纤维蛋白原沉积在儿童过敏性紫癜性肾炎中的意义[J]. 临床儿科杂志,2018,36(3):182-187.
[6]迟妍. 凉血化瘀通络方治疗小儿过敏性紫癜肾炎的临床疗效观察[J]. 中国医药指南,2018,16(4):165.
[7]陈团营, 朱珊, 祝志朋,等. 清热活血方药对过敏性紫癜肾炎患儿t-PA和PAI-1水平的影响[J]. 中华中医药杂志,2018,33(4):1574-1576.
[8]何军民. 凉血肾愈汤配合西药治疗小儿血热阻络型过敏性紫癜性肾炎36例临床观察[J]. 中医儿科杂志, 2016,12(5):52-55.
[2]中华医学会儿科学分会肾脏病学组.紫癜性肾炎的诊断与治疗 (草案) [J].中华儿科杂志, 2001, 39(12):748-749.
[3]汪受传,虞坚尔 .中医儿科学[M].3版.北京:中国中医药出版社,2012: 281.
[4]郑筱萸. 中药新药临床研究指导原则(试行) [M].北京:中国医药科技出版社,2002:61-62.
[5]王凤英, 李晓忠, 王兴东,等. 肾小球内纤维蛋白原沉积在儿童过敏性紫癜性肾炎中的意义[J]. 临床儿科杂志,2018,36(3):182-187.
[6]迟妍. 凉血化瘀通络方治疗小儿过敏性紫癜肾炎的临床疗效观察[J]. 中国医药指南,2018,16(4):165.
[7]陈团营, 朱珊, 祝志朋,等. 清热活血方药对过敏性紫癜肾炎患儿t-PA和PAI-1水平的影响[J]. 中华中医药杂志,2018,33(4):1574-1576.
[8]何军民. 凉血肾愈汤配合西药治疗小儿血热阻络型过敏性紫癜性肾炎36例临床观察[J]. 中医儿科杂志, 2016,12(5):52-55.