【摘要】：目的：通過分析臨床病例，探討糖皮質(zhì)激素治療小兒過敏性紫癜的療效及與中醫(yī)辨證證型的相關(guān)性，以期有助于臨床應(yīng)用。 方法：收集臨床病例，按照臨床實(shí)際用藥情況，將病例分為中藥組和中藥加激素組。并對(duì)兩組病人進(jìn)行中醫(yī)辨證，然后采集癥狀體征、證型、用藥、療效等資料，，建立數(shù)據(jù)庫(kù)，并運(yùn)用SPSS17.0統(tǒng)計(jì)軟件對(duì)兩組患兒的近期療效等進(jìn)行統(tǒng)計(jì)分析，探討其與中醫(yī)證型的相關(guān)性。并隨訪1年，以觀察其遠(yuǎn)期療效。 結(jié)果：1.小兒過敏性紫癜初期以風(fēng)熱、濕熱等陽(yáng)熱性證候?yàn)橹�，加用糖皮質(zhì)激素可延長(zhǎng)治愈時(shí)間，且對(duì)風(fēng)熱傷絡(luò)證較濕熱阻絡(luò)證影響更為顯著。2.加用糖皮質(zhì)激素可縮短血管神經(jīng)性水腫消失時(shí)間，而對(duì)皮膚紫癜、腹痛、關(guān)節(jié)腫痛消失時(shí)間及是否出現(xiàn)腎臟損害、病情反復(fù)情況等無(wú)顯著影響。3.加用糖皮質(zhì)激素可促使原證型向陽(yáng)熱、陰虛、郁滯性證候轉(zhuǎn)化。 結(jié)論：1.過敏性紫癜治療初期加用糖皮質(zhì)激素可延長(zhǎng)病程，且對(duì)腎臟損害無(wú)預(yù)防作用。2.糖皮質(zhì)激素屬辛溫之品，推測(cè)其療效有化腎精為氣，動(dòng)肝氣以升提，行氣祛濕、止癢止痛之功，但可助陽(yáng)化火擾動(dòng)心神，因此臨床應(yīng)合理辨證應(yīng)用激素，并注意藥物間配伍關(guān)系，辨證調(diào)護(hù)預(yù)防藥源性證。
[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.
【學(xué)位授予單位】：山東中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R272

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