目的 探讨玉屏风颗粒联合双嘧达莫片治疗儿童过敏性紫癜的临床疗效。方法 选取2020年1月-2022年10月在皖西卫生职业学院附属医院就诊的85例过敏性紫癜患儿,按照计算机随机排列法分为对照组(42例)和治疗组(43例)。对照组口服双嘧达莫片,3.0 mg/(kg·d),平均分3次服用。治疗组在对照组基础上温水冲服玉屏风颗粒,3~8岁,3次/d,半袋/次,8~12岁,3次/d,1袋/次。两组患儿连续治疗3个月。观察两组临床疗效,比较两组的主要症状消失时间、可溶性髓样细胞表达触发受体样转录因子1(TLT1)、白细胞介素(IL)-9、IL-21、辅助性T细胞(Th17)、调节性T细胞(Treg)、Th17/Treg水平。结果 治疗后,治疗组的总有效率95.35%较对照组的80.95%更高(P<0.05)。治疗后,治疗组患儿皮肤紫癫、腹痛、关节症状、肾脏症状消失时间均短于对照组(P<0.05)。治疗后,两组的血清TLT1、IL-9水平明显降低,血清IL-21水平明显升高(P<0.05);治疗后,治疗组的血清TLT1、IL-9水平低于对照组,血清IL-21水平高于对照组(P<0.05)。治疗后,两组的Th17、Th17/Treg水平低于治疗前,Treg水平高于治疗前(P<0.05);治疗后,治疗组的Th17、Th17/Treg水平低于对照组,Treg水平高于对照组(P<0.05)。结论 玉屏风颗粒联合双嘧达莫片可用于儿童过敏性紫癜,能够改善临床症状,减轻炎症反应,调节免疫功能平衡,且药物安全性良好。

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

安徽省卫生计生委科研计划项目(2016QK082)