摘要:
Objective To investigate the clinical efficacy of Qishen Xiaodian Decoction combined with laser acupoint irradiation for treatment of recurrent Hen?ch-Sch?nlein purpura (HSP) in children. Methods Totally 120 cases of children with recurrent HSP were divided into treatment group and control group according to the digital random table method, with 60 cases in each group. The control group was given anti-allergy, hormones, immunosuppressive agents and other conventional treatment for 4 weeks, while the treatment group was treated with Qishen Xiaodian Decoction based on conventional treatment, 1 dose each day, morning and night (age 4–5 take 1/3 dose, age >5–10 take the half dose, and age >10–14 take the whole dose), for 4 weeks. Zusanli, Xuehai, and Sanyinjiao acupoints were under laser vertical irradiation, 12 min for each time, once a day for 2 weeks. The disappearing time of the main symptoms and the total effective rate of the two groups were compared. Peripheral blood contents of Th17 and Treg cells and serum interleukin-17 (IL-17), and transforming growth factor β1 (TGF-β1) level before and after the treatment were observed. The recurrence rate in 6 months and in 12 months of the two groups were compared. Results The disappearing time of rash, abdominal pain and joint swelling pain and kidney damage of the treatment group were less than those of the control group (P5~10岁用半量,>10~14岁用全量),连续治疗4周.取足三里、血海、三阴交,激光垂直照射,每次12 min/穴,每日1次,连续治疗2周.比较2组主要症状(皮疹、腹痛、关节肿痛、肾损伤)消失时间及临床疗效.观察2组治疗前后外周血Th17、Treg细胞含量和血清白细胞介素-17(IL-17)、转化生长因子-β1(TGF-β1)水平.比较治疗后6、12个月复发率.结果 治疗组皮疹、腹痛、关节肿痛和肾损伤消失时间短于对照组(P<0.01).治疗组总有效率为95%(57/60),对照组为80%(48/60),2组比较差异有统计学意义(P<0.05).与治疗前比较,2组治疗后Th17细胞含量及血清IL-17、TGF-β1水平降低,Treg细胞含量升高(P<0.01);与对照组比较,治疗组治疗后Th17细胞含量和血清IL-17水平降低(P<0.01).治疗组治疗后6、12个月时复发率低于对照组,2组比较差异有统计学意义(P<0.05).结论 在西医常规治疗基础上,芪参消癜汤联合激光穴位照射辅助治疗儿童复发性HSP可快速缓解症状,降低复发率.