RESUMO
Objective:To evaluate the efficacy of Jiedu-Huaban Decoction combined with montelukast sodium chewable tablets in the treatment of children with henoch schonlein purpura (HSP). Methods:A total of 80 children with HSP and blood heat syndrome who met the inclusion criteria, from January 2017 to December 2019, were randomly divided into two groups by random number table method, 40 in each group. The control group took montelukast sodium chewable tablets at night, and the study group took Jiedu-Huaban Decoction on the basis of the control group. Both groups were treated for 2 weeks. The disappearance time of gastrointestinal disease, skin purpura, kidney disease, joint swelling and pain were observed. The improvement score of skin purpura was evaluated before and after treatment. The serum levels of IL-6, IL-4, interferon-γ (IFN-γ) and TNF-α were detected by ELISA, and the levels of IgG, IgA and IgM. The T lymphocyte subsets (CD4 + and CD8 +) were measured by nephelometry, and the CD4 +/CD8 +values were calculated. The clinical efficacy was evaluated. Results:The total effective rate was 87.5% (35/40) in the study group and 67.5% (27/40) in the control group, with significant difference between the two groups ( χ2 =4.588, P=0.032). The disappearance time of gastrointestinal disease, skin purpura, kidney disease and joint swelling and pain in the study group were significantly earlier than those in the control group ( t=7.802, 12.167, 7.309, 9.365, all Ps<0.001). After treatment, the serum levels of IL-6, IL-4, IFN-γ and TNF-α in the study group were significantly lower than those in the control group ( t=9.319, 6.738, 8.221, 6.553, all Ps<0.001). The improvement score of skin purpura at 1 week after treatment (2.75 ± 0.69 vs. 3.92 ± 0.83, t=6.856) and 2 weeks after treatment (0.41 ± 0.15 vs. 1.55 ± 0.37, t=18.095) in the study group were significantly lower than those in the control group ( P<0.01). After treatment, the level of IgG, CD4 +, CD4 +/CD8 + in the study group were significantly higher than those in the control group ( t=5.160, 4.558, 3.442, all Ps<0.01), the level of IgA, IgM, CD8 + in the study group were significantly lower than those in the control group ( t=2.614, 6.712, 5.468, all Ps< 0.05). During the treatment, the incidence of adverse reactions in the control group was 17.5% (7/40), and that of the study group was 15.0% (6/40), wherer there was no statistical difference between the two groups ( χ2=0.092, P=0.762). Conclusion:Jiedu-Huaban Decoction combined with montelukast sodium chewable tablets can improve the clinical symptoms of children with HSP and blood heat syndrome, reduce the body inflammatory reaction, improve immunity, with good safety.
RESUMO
Objective To study the efficacy of Liangxue-Zhuyu decoction combined with montelukast in the treatment of henoch schonlein purpura (HSP) and its influence on immunologic function. Methods A total of 95 HSP children treated in department of pediatrics from February 2014 to December 2016 were enrolled, and then were randomly divided into observation group (n=48) and control group (n=47), meanwhile another 48 healthy children admitted to a medical examination were selected as the healthy group. The patients in the control group were given the treatment of oral montelukast sodium chewable tablets before sleeping (the dose:2-6 years old 4 mg/d, 6-14 years old 5 mg/d), and the patients in the observation group accepted the therapy of Liangxue-Zhuyu decoction based on the treatment of the control group.The course of the treatment in the two groups were 30d. The time of clinical symptom regression and adverse reactions were recorded, and the clinical efficacy was evaluated. Monoclonal antibody immunofluorescence method and Enzyme-linked immunosorbent assay (ELISA) were used to detect the levels of serum T lymphocyte subsets and INF-γ and IL-10 before and after treatment, and their differences among three groups were compared. Results The effective rates of the observation group was 95.8% (46/48), which was significantly higher than 76.6% (36/47) of control group (x 2=7.441,P<0.05).The subsided time of the symptoms,including purpura(5.0 ± 1.3 d vs.6.6 ± 2.6 d,t=3.816), abdominal pain(3.1 ± 2.1 d vs.4.1 ± 2.6 d,t=2.139),joint pain(4.3 ± 1.5 d vs.5.4 ± 1.9 d,t=3.416),fecal occult blood(4.5 ± 1.5 d vs.6.1 ± 1.9 d,t=4.404)of the observation group were significantly shorter than those of the control group(P<0.05).After the treatment,the CD4(45.14% ± 9.32% vs.41.02% ± 9.97%),CD8(25.10% ± 4.69% vs.21.52% ± 5.71%)of the observation group was significantly higher than those of the control group, and the CD4/CD8(1.62 ± 0.32 vs.1.95 ± 0.35)and IL-10(33.07 ± 1.86 pg/ml vs.53.92 ± 2.98 pg/ml)of the observation group was significantly lower than this of the control group (P<0.05). Conclusions The efficacy of the Liangxue-Zhuyu decoction combined with montelukast for HSP was definite,and the effect was rapid with little side effects. The mechanism might be related to regulating the secretion of T lymphocyte and IL-10, thereby to correct Th1/Th2 cell balance and disturbance of immune function.
RESUMO
Objective To study the montelukast sodium chewable tablets for the treatment of obstructive sleep apnea hypopnea syndrome(OSAHS)patients and treatment of tonsil and adenoid effect.Methods 84 cases of OSAHS patients in our hospital from January 2014 to August 2016 were randomly divided into the observation group and the control group,42 cases in each group.The control group was treated with conventional symptomatic treatment,on this basis,the patients in the observation group received montelukast sodium chewable tablets treatment,compared the two groups of the total efficiency,and compared before and after treatment of symptoms total score,apnea hypopneaIndex(AHI),the lowest arterial oxygen saturation(LSaO2),and adenoid and tonsil classification indexing.Results the total efficiency of observation group(90.48％)was significantly higher than the control group(69.04％,χ2=5.97,P<0.05); after treatment,the observation group of the total symptom score and AHI were significantly lower than the control group(P<0.05),LSaO2 was significantly higher than the control group(P<0.05),adenoid grade one and grade two were significantly higher than the control group(χ2=9.82,P<0.05),there was no significant difference between the one and two degrees of tonsil dividing ratio.Conclusion The clinical efficacy of montelukast sodium chewable tablets in the treatment of children with OSAHS is significant,can effectively reduce the volume of tonsil and adenoid body,and improve the clinical symptoms and sleep treatment significantly,which is worthy of clinical promotion.
