糖皮质激素治疗过敏性紫癜的疗效与证型的相关性分析

发布时间：2019-04-01 21:29

【摘要】：目的：通过分析临床病例，探讨糖皮质激素治疗小儿过敏性紫癜的疗效及与中医辨证证型的相关性，以期有助于临床应用。方法：收集临床病例，按照临床实际用药情况，将病例分为中药组和中药加激素组。并对两组病人进行中医辨证，然后采集症状体征、证型、用药、疗效等资料，，建立数据库，并运用SPSS17.0统计软件对两组患儿的近期疗效等进行统计分析，探讨其与中医证型的相关性。并随访1年，以观察其远期疗效。结果：1.小儿过敏性紫癜初期以风热、湿热等阳热性证候为主，加用糖皮质激素可延长治愈时间，且对风热伤络证较湿热阻络证影响更为显著。2.加用糖皮质激素可缩短血管神经性水肿消失时间，而对皮肤紫癜、腹痛、关节肿痛消失时间及是否出现肾脏损害、病情反复情况等无显著影响。3.加用糖皮质激素可促使原证型向阳热、阴虚、郁滞性证候转化。结论：1.过敏性紫癜治疗初期加用糖皮质激素可延长病程，且对肾脏损害无预防作用。2.糖皮质激素属辛温之品，推测其疗效有化肾精为气，动肝气以升提，行气祛湿、止痒止痛之功，但可助阳化火扰动心神，因此临床应合理辨证应用激素，并注意药物间配伍关系，辨证调护预防药源性证。
[Abstract]:Aim: to investigate the therapeutic effect of glucocorticoid on Henoch-Schonlein purpura (Henoch-Schonlein purpura) and its correlation with syndrome differentiation of traditional Chinese medicine (TCM) by analyzing clinical cases. Methods: to collect clinical cases and divide them into two groups according to the clinical situation of drug use: traditional Chinese medicine group and traditional Chinese medicine plus hormone group. Then collect the data of symptoms and signs, syndrome type, drug use, curative effect and so on, establish a database, and use SPSS17.0 statistical software to analyze the short-term curative effect of the two groups of children, and then collect the data of symptoms and signs, syndrome type, drug use, curative effect and so on. To explore the correlation between TCM syndrome type and TCM syndrome type. All patients were followed up for 1 year to observe the long-term effect. Results: 1. In the early stage of Henoch-Schonlein purpura (Henoch-Schonlein purpura), the syndrome of wind-heat, damp-heat and other yang-heat syndrome was dominant. The addition of glucocorticoid could shorten the time of disappearance of vascular and neuroedema, but had no significant effect on skin purpura, abdominal pain, joint swelling and pain, kidney damage or not. 3. The addition of glucocorticoid can promote the transformation of the original syndrome type to yang heat, yin deficiency and stagnation syndrome. Conclusion: 1. The early treatment of Henoch-Schonlein purpura with glucocorticoid can prolong the course of disease and has no preventive effect on renal damage. 2. Glucocorticoid belongs to the product of Xin Wen, and speculates that its curative effect has the function of transforming kidney essence into qi, moving liver qi to lift up, removing qi and dampness, relieving itching and relieving pain, but it can help Yang to turn fire and disturb heart and mind, so the clinical application of hormone should be reasonable according to differentiation of symptoms and signs. And pay attention to the compatibility of drugs, syndrome differentiation of prevention and prevention of drug-derived syndrome.
【学位授予单位】：山东中医药大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R272

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