中医活血凉血化瘀法对过敏性紫癜肾损害防治临床探究.doc

中医活血凉血化瘀法对过敏性紫癜肾损害防治临床探究 　作者：陈汉华，黄清明，杨京华，李丹，许尤佳，杜淑娟，胡彬文，吴伟霞，郑燕霞 【摘要】 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①β2-微球蛋白（β2-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CD4/CD8，SOD和MDA，差异无统计学意义，两组治疗后CD4/CD8，SOD和MDA，差异有统计学意义。两组各治疗前后ALb、β2-M，差异有统计学意义。两组各治疗前后血T细胞亚群(CD4/CD8)，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（Plt;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（Plt;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。 【关键词】 过敏性紫癜； 肾炎； 中药疗法； 活血凉血化瘀药 ChinaAbstract：ObjectiveTo observe the LiangXueHuoXueHuaYu decoction’s clinical curative effect in the prevention and therapy on the kidney injury caused by anaphylactoid purpura.MethodsThrough 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 β2-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 β2-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 CD4/ CD8，SOD and MD