关键词:

过敏性紫癜性肾炎, 槐杞黄颗粒, 免疫调节, Th1/Th2相关细胞因子, 儿童

Abstract:

Objective　To explore the clinical efficacy and immune regulation effect of Huaiqihuang granules on children with hypersensitive purpura nephritis (HSPN). Methods　This study is a single-center, non-randomized, controlled clinical trial. A total of 30 children diagnosed with HSPN who were admitted to the pediatrics department of Zhongshan People's Hospital from January 2022 to December 2023 were selected for the HSPN group. Based on the family's willingness to use Huaiqihuang granules for treatment, the patients were divided into a conventional group and a Huaiqihuang group, with 15 cases in each group. The conventional group included 6 males and 9 females, with an average age of (8.07±2.17) years. The Huaiqihuang group included 10 males and 5 females, with an average age of (7.13±2.43) years. A healthy control group consisted of 30 healthy children who underwent health check-ups at the same hospital, matched for gender and age with the HSPN group. The healthy control group included 18 males and 12 females, with an average age of (6.95±2.08) years. The conventional group received standard treatment, while the Huaiqihuang group received oral Huaiqihuang granules as an adjunctive therapy. Both groups were treated for 1 month. The differences of clinical symptoms, laboratory indexes and immunological indexes were compared among the groups. Statistical analysis was performed using t test, Mann-Whitney U test, and Fisher's exact probability method. Results　In the HSPN group, levels of Th1-type cytokines IL-2 and interferon-gamma (IFN-γ) were lower than those in the healthy control group [(2.24±0.90) ng/L vs. (3.80±1.20) ng/L; 2.52 (1.04, 3.87) ng/L vs. 5.26 (3.39, 5.87) ng/L] (both P<0.05). Th2-type cytokines IL-4 and IL-6 were higher in the HSPN group than in the healthy control group [5.04 (3.75, 5.98) ng/L vs. 4.08 (3.73, 4.44) ng/L; 15.38 (8.85,26.31) ng/L vs. 3.65 (2.36, 5.21) ng/L], while IL-10 was lower in the HSPN group [(1.19±0.74) ng/L vs. (5.02±1.82) ng/L], with all differences being statistically significant (all P<0.05). After treatment, levels of IL-2, IL-10, and IFN-γ in the Huaiqihuang group were higher than those in the conventional group [(3.66±1.27) ng/L vs. (2.73±1.00) ng/L; 3.26 (2.50, 3.95) ng/L vs. 2.63 (2.39, 3.48) ng/L; (4.84±1.32) ng/L vs. (3.63±1.16) ng/L], while IL-4, IL-6 levels were lower in the Huaiqihuang group [(3.43±1.76) ng/L vs. (4.85±1.69) ng/L; 3.00 (2.42, 3.52) ng/L vs. 3.02 (2.51, 4.74) ng/L]. The levels of CD3⁺, absolute CD3⁺, CD4⁺, CD4⁺/CD8⁺, and NK cells were higher in the Huaiqihuang group, while CD8⁺, NKT, IgE, IgA, and C3 levels were lower compared to the conventional group, with all differences being statistically significant (all P<0.05). The urinary protein clearance time in Huaiqihuang group was shorter than that in routine group [(14.67±6.25) days vs. (20.67±8.02) days], and the total incidence of secondary infection was lower than that in routine group [13.3% (2/15) vs. 60.0% (9/15)], with statistically significant differences (all P<0.05). Conclusion　Huaiqihuang granules can significantly improve the clinical symptoms of children with HSPN by regulating immune disorders, reduce the occurrence of secondary infections, and have good clinical efficacy.

Key words:

Hypersensitive purpura nephritis, Huaiqihuang , granules, Immune regulation, Th1/Th2 cell-related cytokines, Children