Effect Of Astragalus Granule On Immune Function In Children With Henoch-Schonlein Purpura

Objective To observe the clinical efficacy of Astragalus Granules Combined with conventional western medicine in treating children with anaphylactoid purpura of Qi-deficiency type,and to determine the levels of IL-10+CD4+T cells and related cytokines in peripheral blood,and to explore the mechanism of Astragalus granules in the treatment of anaphylactoid purpura,so as to provide some basis for clinical treatment.Methods Select the children with Henoch-Schonlein purpura admitted to our hospital from December 2017 to December 2018,combined with TCM syndrome differentiation and typing,40 children with Qi-deficiency blood group were included in the study.They were randomly divided into two groups.Group A: 20 cases were given conventional western medicine treatment,Group B: 20 cases were given conventional western medicine combined with Huangqi granule oral treatment.The course of treatment was 10 days.All the children who participated in the study were observed under the principle of informed consent signed by their guardians.The basic data(age,sex,etc.)of each child were recorded in detail,and the changes of symptoms were monitored dynamically.The results of laboratory tests(three routine tests,serum Ig A,Ig G,Ig M and T lymphocyte subsets)were recorded.The curative effect of TCM syndromes was evaluated before and after treatment.Another 20 healthy children in the physical examination center of our hospital at the same time were selected as group C(healthy control group).The children in this group had no history of respiratory tract infection,medication,allergic diseases and other chronic diseases,and no history of allergic and hereditary diseases in the family in the past two weeks.Anticoagulant peripheral blood was collected before and after treatment in each group.Peripheral blood mononuclear cells were extracted.IL-10+CD4+T cells were detected by flow cytometry.Serum levels of interleukin-10,IFN-gamma and TGF-beta were measured by enzyme-linked immunosorbent assay(ELISA).Excel was used to input all collected data to establish the database,and Spss 17.0 was used for statistical analysis.Results1.There was no significant difference in symptom score and total score between group A and group B before treatment(all P > 0.05);after treatment,the score of group A and group B decreased significantly(all P < 0.01),and the score of group B decreased more significantly.There were significant differences before and after treatment in each group.The effective rate of group A was85%,and that of group B was 95%.After analysis,the difference was significant(0.01 < P < 0.05).The effective rates of the two groups were 95% and 100%,respectively.There was no significant difference.2.There was no significant difference in white blood cells between group A and group B before and after treatment.Before treatment,there was no significant difference in NLR between the two groups.After treatment,the NLR of the two groups was 2.7 + 0.52,2.3+ 0.4,P = 0.01 < 0.05,with statistical significance.Before treatment,there was no difference in PLT between the two groups(P = 0.339),and after treatment,there was significant difference between the two groups(P = 0.012 < 0.05).Before treatment,there was no significant difference in Ig G and Ig M concentration between group A and group C,group B and group C,P > 0.05,and Ig A concentration had statistical significance,P < 0.001;There was no significant difference in Ig A concentration between group A and group B,P was 0.255.After treatment,the plasma Ig A concentration in group A and group B decreased to different degrees,and there was a significant difference before and after treatment,P < 0.001;after treatment,there was a significant difference between groups A and B,P was 0.004.There was no significant difference in T cell subsets between groups A and B before treatment.Compared with group C,CD4+cells decreased,CD8+increased and CD4+/ CD8+decreased in groups A and B.The recovery of CD4+/CD8+in group A and B after treatment was more significant than that before recovery.3.Before treatment,the levels of IL-10+CD4+T cells in peripheral blood of children in group A and B were lower than those in group C,the difference was statistically significant(P < 0.05);the levels of IL-10+CD4+T cells in peripheral blood of children in group A and B had no significant difference,which could be compared. The levels of IL-10+CD4+T cells in peripheral blood of group B were significantly different before and after treatment(P < 0.05),but there was no significant difference in group A.After treatment,the level of IL-10+CD4+T cells in group A and B was 0.018,and the difference was statistically significant.4.The levels of serum cytokines IFN-gamma,IL-10 and TGF-beta in three groups were not significantly different before treatment between group A and group B(P > 0.05).The levels of IFN-gamma,IL-10 and TGF-beta in group A were lower than those in group C(P< 0.01),while the levels of TGF-beta were significantly higher than those in group C(P < 0.01).After treatment,the levels of IFN-gamma and IL-10 in group A and B were significantly higher than those before treatment(P < 0.01),and those in group B were significantly higher than those in group A(P < 0.05),while the levels of TGF-beta in group A and B were significantly lower than those before treatment(P < 0.01),and those in group B were significantly lower than those in group A(P < 0.05).Conclusions The clinical effect of Astragalus granule combined with routine western medicine in treating children’s anaphylactoid purpura is better than that of routine western medicine.The specific manifestation is that Astragalus granule combined with routine western medicine has higher cure rate and marked efficiency.There are cellular immunity and humoral immunity disorders in children’s anaphylactoid purpura.The treatment of Astragalus granule combined with Western Medicine may affect the level of T cell proliferation and immune function,differentiation and release of inflammatory mediators.