ABSTRACT
Henoch-schonlein purpura nephritis (HSPN) is a pathological renal manifestation of systemic allergic vasculitis caused by the deposition of immune complexes in small blood vessels. It occurs most frequently in children and the main manifestation is hematuria seen under microscope. At present, western medical doctors have not reached a consensus on the therapeutic regimen of HSPN, but they all have agreed that early diagnosis and early treatment in time are of great significance to the prognosis of this disease, especially the children with persistent proteinuria should be actively and properly treated. In recent years, with the deepening understanding of HSPN in traditional Chinese medicine, it is considered that the blood stasis is the key factor of the pathogenesis, therefore, the treatment of promoting blood circulation and removing blood stasis is applied through the whole therapeutic course. This study summarizes the various aspects of HSPN treatment based on the blood stasis as the key factor of the pathogenesis.
ABSTRACT
Objective To investigate the clinical efficacy of Huoxuehuayu liquid in treating children with Henoch-Schonlein purpura nephritis (HSPN). Methods Sixty children with HSPN admitted to the Department of Traditional Chinese Medicine (TCM) of Tianjin Children's Hospital were enrolled, and they were randomly divided into a Huoxuehuayu liquid group and a western medicine control group, 30 cases in each group. In Huoxuehuayu liquid group, modified Huoxuehuayu prescription was given, modification means the ingredients of prescription can be added and subtracted according to patients TCM syndrome manifestations (ingredients of prescription: Faeces Togopteri, carbonized Pollen Typhae, Radix Angelicae Sinensis, Herba Cirsii, Cortex Moutan Radicis, carbonized Nodus Nelumbinis Rhizomatis, each 10 g, Poria, Polyporus Umbellatus, Rhizoma Alismatis, carbonized Herba Schizonepetae, each 6 g, Radix Notoginseng 3 g, in patients accompanied by heat, Rhizoma Imperatae and Herba Lophatheri were added, in patients accompanied by dampness Semen Phaseoli and Semen Euryales were added, and in patients accompanied by deficiency, Radix Astragali seu Hedysari, Rhizoma Polygonati, Radix Polygoni Multiflori were added),1 dose per day, 2 times a day; in western medicine treatment group, vitamin C, aminopeptin, loratadine syrup were given; after 30 days of treatment in two groups, the changes of clinical signs, laboratory indexes and clinical curative effect were observed. Results After treatment of TCM method as above, the numbers of patients with skin purpura subsided (13 cases vs. 10 cases), partially subsided (12 cases vs. 9 cases), with occult blood <+ (13 cases vs. 10 cases), with 24 hours urinary protein transferring to normal (25 cases vs. 20 cases), with urine erythrocyte in sediment < 3 cells/HP (11 cases vs. 9 cases), with urinary streaming type red blood cells < 30 cells/μL (11 cases vs. 8 cases) in Huoxuehuayu liquid group were higher significantly than those in western medicine control group (all P < 0.05). After treatment, there were 13 cases with marked therapeutic effect, 12 cases with effect and 5 cases without effect, the total therapeutic effect being 83.33% (25 cases) in Huoxuehuayu liquid group; while in western medicine control group, there were 10 cases with marked effect, 9 cases with effect and 11 cases without effect, the total therapeutic effect being 63.33% (19 cases); total therapeutic effect rate in Huoxuehuayu liquid group was obviously higher than that in western medicine control group, the difference was statistically significant (P < 0.05). Conclusions Huoxuehuayu liquid can obviously improve the laboratory indexes and clinical signs, and elevate the clinical total therapeutic effective rate in treatment of children with HSPN; since the curative effect is definite, it is worthwhile to be used extensively in clinical practice.