Clinical Observation Of Huaiqi Huang Granule In Children With Henoch-schonlein Purpura Nephritis

Objective: To observe the clinical efficacy and safety of Huaiqi Huang Granule in the treatment of children with Henoch-Schonlein purpura nephritis(HSPN)by comparing different treatment methods,and to further guide the clinical medication of children with Henoch-Schonlein purpura nephritis.Method:A total of 60 children with Henoch-Schonlein purpura nephritis(HSPN)admitted to the pediatric nephrology department of the Second Hospital of Hebei Medical University from January 2017 to December 2018 were divided into three groups: group A: mixed treatment group(routine + Huaiqi Huang Granule treatment group),group B: routine treatment group,group C: single Huaiqi Huang Ge.Granule treatment group(small and medium 24-hour proteinuria in children with HSPN),the three groups were 20 cases.At admission,before discharge,and after discharge(2-28 weeks),all the children were tested for laboratory related indicators,including urinary sedim-ent,24-hour urinary protein,blood routine,liver function,kidney function,blood lipid,blood sugar,B lymphocyte,T lymphocyte subsets,complement,and recurrence.The clinical efficacy of each group was compared.Result: 1 Clinical observation 1.1 Urinary protein and urinary erythrocyte count in A and B groups1)Compared with group B,group A was shorter than group B in two consecutive times of negative conversion of urinary protein,with statistical significance(P<0.05).[(10.40 + 4.38)weeks] vs [(16.27 + 8.28)weeks]2)Comparing the recovery time of urinary sediment erythrocyte for two consecutive times,group A was shorter than group B,with statistical significance(P<0.05).[(17.22 + 7.06)weeks] vs [(21.21 + 6.59)weeks] 1.2 Total effective rate of children with HSPN1)Comparing the total effective rate of group A and group B,group A was better than group B,with statistical significance(P<0.05).(Z=-2.314,P=0.021)2)Comparing the total effective rate between group B and group C,group B was better than group C,with statistical significance(P<0.05).(Z=-2.215,P=0.027)2 Function of T and B lymphocyte in peripheral blood of children with HSPN 2.1 Relevant immunological indexes in group A,B and C before and after treatment1)The immune function of T lymphocyte subsets in group A was improved after treatment compared with that before treatment(P<0.05),but there was no significant difference in B lymphocyte function before and after treatment(P>0.05).(CD3+,CD4+,CD8+,CD4/CD8:t values were-8.176,-8.119,2.686,-7.261,P<0.005;IgA,IgG,IgM: T values were-0.253,0.495,-0.912,P> 0.05).2)Comparing the immunological indexes of group B before and after treatment,CD3 + and CD4 + increased after treatment,with statistical significance(P<0.05),and CD4/CD8 increased compared with before treatment,but without statistical significance(P>0.05);there was no significant difference in B lymphocyte function before and after treatment,and there was no statistical significance(P > 0.05).(CD3+:t=-3.007,P=0.007,CD4+:t=-6.623,P=0.000,CD8+:t=-0.565,P=0.579,CD4/CD8:t=-2.360,P=0.029;IgA,IgG,IgM:t values are-1.300,-0.114,-1.632,P>0.05).3)The function of T lymphocyte and B lymphocyte in group C was better than that before treatment,but there was no statistical significance(P > 0.05).(CD3+,CD4+,CD8+,CD4/CD8:t values were-1.625,-1.322,-0.201,0.840,P>0.005;IgA,IgG,IgM: T values were-1.218,-0.240,-1.807,P > 0.05).2.2 Detection results of T cell subsets in group A and group B after treatment1)CD3+% in group A was significantly higher than that in group B(P < 0.05).[(72.86 + 5.94%)vs(68.03 + 8.59%),t = 2.067,P = 0.046]2)CD3+CD8+% in group A was significantly lower than that in group B(P < 0.05).[(26.52 + 3.56%)vs(30.84 + 3.45%),t=-3.897,P = 0.000]3)CD4/CD8 in group A was significantly higher than that in group B(P < 0.05).[(1.55 + 0.36%)vs(1.21 + 0.13%),t = 3.91,P = 0.000].3 Recurrence of HSPN in group A and group BThere were 4 cases of recurrence in 40 children at 6 months of follow-up,including 1 case in group A and 3 cases in group B.The recurrence rate between the two groups was statistically significant(P<0.05).(Z=-5.39,P=0.000).4 Safety evaluation of group CComparing the results of biochemical indicators at 6 time points before treatment,2 weeks,6 weeks,12-14 weeks,20 weeks and 28 weeks in group C,there was no significant difference in ALT,AST,creatinine and urea nitrogen at 6 time points(P > 0.05).Conclusion:1.Huaiqi Huang Granule can significantly improve T and B lymphocyte function and reduce the infection and recurrence rate during the follow-up period by regulating the immune system.2.Huaiqi Huang Granule can significantly reduce 24-hour urinary protein quantification and urinary red blood cell count,thus delaying the impairment of renal function.3.The incidence of adverse events of Huaiqi Huang Granule is very low,and it is a safe drug for clinical use.