目的 观察防风通圣丸和甲泼尼龙两种药物联合治疗对过敏性紫癜患儿的临床疗效。方法 研究对象来源于2023年4月—2025年6月平顶山市中医医院儿科收治的90例过敏性紫癜患儿，按照随机数字表法分为对照组和治疗组，各纳入45例。对照组静脉滴注注射用甲泼尼龙琥珀酸钠，起始剂量2 mg/(kg·d)，单次最大剂量应≤60 mg，1次/d，连续治疗1周，1周后改为晨起顿服甲泼尼龙片，1～2 mg/(kg·d)，每3～5天减少10%～20%，总疗程2周。治疗组在对照组基础上口服防风通圣丸，3岁≤年龄≤6岁，3 g/次，2次/d；6岁＜年龄≤10岁，6 g/次，2次/d；10岁＜年龄≤14岁，9 g/次，2次/d。两组连续治疗2周。观察两组临床疗效和症状缓解时间，比较两组免疫功能和血清炎症因子水平的变化情况。结果 治疗后，治疗组总有效率是97.78%，显著高于对照组的77.78%（P＜0.05）。与对照组相比，治疗组腹痛消失时间、皮肤紫癜消退时间及关节肿痛消退时间更短（P＜0.05）。治疗后，两组血清免疫球蛋白G（IgG）、免疫球蛋白M（IgM）及免疫球蛋白A（IgA）水平均较治疗前显著下降（P＜0.05）；治疗后治疗组患儿IgG、IgM、IgA水平低于对照组（P＜0.05）。治疗后，两组血清白细胞介素-6（IL-6）、超敏C反应蛋白（hs-CRP）及肿瘤坏死因子-α（TNF-α）水平均显著降低（P＜0.05）；且治疗后，治疗组患儿血清IL-6、hs-CRP、TNF-α水平均低于同期对照组（P＜0.05）。结论 对于过敏性紫癜患儿，防风通圣丸与甲泼尼龙联合治疗不仅能明显提升整体疗效、改善机体免疫状态，还可发挥较强的抗炎作用，更快缓解相关临床症状，具有临床推广应用价值。

Objective To observe the effects of Fangfeng Tongsheng Pills combined with methylprednisolone in treatment of allergic purpura in children. Methods The research subjects were 90 children with allergic purpura who were admitted to the Pediatrics Department of Pingdingshan Hospital of Traditional Chinese Medicine from April 2023 to June 2025. They were divided into control group and treatment group according to random number table method, with 45 cases in each group. Children in control group were given intravenous infusion of Methylprednisolone Sodium Succinate for injection, initial dose of 2 mg/(kg∙d), with a maximum single dose of no more than 60 mg, administered once daily for 1 week. After 1 week, the children were switched to taking Methylprednisolone Tablets in the morning, at a dose of 1 — 2 mg/(kg∙d), with a 10% — 20% reduction every 3 — 5 d, for a total treatment course of 2 weeks. Children in treatment group were orally administered Fangfeng Tongsheng Pills on basis of control group. For children aged 3 years and up to 6 years, the dosage was 3 g/time, twice daily, for children aged 6 years and up to 10 years, the dosage was 6 g/time, twice daily, for children aged 10 years and up to 14 years, the dosage was 9 g/time, twice daily. Both groups were treated continuously for 2 weeks. The clinical efficacy and symptom relief time of two groups were observed, and the changes in immune function and serum inflammatory factor levels of two groups were compared. Results After treatment, the total effective rate of treatment group was 97.78%, significantly higher than that of control group (77.78%) (P < 0.05). Compared with control group, disappearance time of abdominal pain, regression time of skin purpura and regression time of joint swelling and pain in treatment group were shorter (P < 0.05). After treatment, the levels of serum immunoglobulin G (IgG), immunoglobulin M (IgM), and immunoglobulin A (IgA) in both groups were significantly lower than those before treatment (P< 0.05). After treatment, the levels of IgG, IgM, and IgA in children of treatment group were lower than those of control group (P < 0.05). After treatment, the levels of serum interleukin-6 (IL-6), high-sensitivity C-reactive protein (hs-CRP), and tumor necrosis factor-α (TNF-α) in both groups were significantly lower (P < 0.05). And after treatment, the levels of serum IL-6, hs-CRP, and TNF-α in children of treatment group were lower than those of control group at the same period (P < 0.05). Conclusion For children with allergic purpura, the combined treatment of Fangfeng Tongsheng Pills and methylprednisolone not only significantly improves the overall therapeutic effect and enhances the body’s immune status, but also has a strong anti-inflammatory effect and can more quickly alleviate related clinical symptoms. Therefore, it has clinical application value and can be promoted for wider use.

R985

河南省第三批中医药青苗人才项目[豫卫中医药科教(2024)4号第48号]