The clinical efficacy of modified Rhinoceros Dihuang decoction in the treatment of children with henoch-sch?nlein purpura
10.3969/j.issn.1008-9691.2025.03.012
- VernacularTitle:加味犀角地黄汤治疗小儿过敏性紫癜的临床疗效
- Author:
Yanyan SHEN
1
;
Yu'an GENG
;
Zhijing XU
Author Information
1. 郑州市中医院儿科,河南 郑州 450000
- Publication Type:Journal Article
- Keywords:
Henoch-Sch?nlein purpura;
Modified Rhinoceros Dihuang decoction;
Bleeding due to blood-heat syndrom;
Inflammatory cytokines;
Immune function
- From:
Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care
2025;32(3):321-325
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the clinical efficacy of modified Rhinoceros Dihuang decoction in the treatment of children with henoch-sch?nlein purpura(HSP)of the"bleeding due to blood-heat syndrome"pattern in traditional Chinese medicine(TCM).Methods A total of 72 pediatric patients diagnosed with HSP and admitted to Zhengzhou Hospital of Traditional Chinese Medicine from June 2021 to June 2023 were enrolled and divided into two groups(n=36 each):control group and observation group.The control group received conveational Western medical treatment,while the observation group received additional treatment with modified Rhinoceros Dihuang decoction based on conventional therapy.The decoction was composed of:Herba Agrimoniae,Radix Rehmanniae,Radix Arnebiae seu Lithospermi,Radix Rubiae,15 g each;Cornu Bubali,30 g,Rhizoma Imperatae,20 g;Cortex Moutan and Radix Paeoniae Rubra,10 g each.The herbs were decocted once daily,dosed according to age:100 mL for ages 3-6,150 mL for 7-11,and 200 mL for 12-14 years old,administered twice daily for 10 days.Outcome measures included clinical efficacy,symptom scores(distribution,color,and morphology of purpura),inflammatory markers[interleukins(IL-17,IL-9),tumor necrosis factor-α(TNF-α)],immune function indicators[T lymphocyte subsets(CD4+,CD8+,CD4+/CD8+)and immunoglobulins(IgA,IgM,IgG)],quality of life,and adverse events.Results After treatment,the symptom scores,inflammatory factors,CD8+,IgA,and IgM levels in the observation group were significantly lower than those in the control group[purpura distribution score:1.03±0.20 vs.1.85±0.27,purpura color score:0.95±0.18 vs.1.76±0.31,purpura morphology score:0.94±0.16 vs.1.76±0.28;IL-17(ng/L):19.84±2.31 vs.26.12±2.63,IL-9(ng/L):20.40±4.19 vs.34.16±6.31,TNF-α(ng/L):13.61±2.05 vs.22.17±2.13;CD8+:0.259±0.040 vs.0.423±0.040,IgA(g/L):1.26±0.24 vs.1.81±0.32,IgM(g/L):1.24±0.19 vs.1.54±0.26,all P<0.05],CD4+,CD4+/CD8+,and IgG levels,as well as the pediatric quality of life inventory 4.0(PedsQL4.0)score were significantly higher in the observation group than in the control group[CD4+:0.461±0.046 vs.0.423±0.040,CD4+/CD8+:1.780±0.330 vs.1.450±0.270,IgG(g/L):11.22±1.75 vs.9.41±1.84,PedsQL4.0 score:83.62±6.54 vs.75.54±12.32,all P<0.05].The total clinical efficacy rate in the observation group was significantly higher than that in the control group[94.44%(34/36)vs.72.22%(26/36),P<0.05].No significant adverse reactions were observed in either group.Conclusion Modified Rhinoceros Dihuang decoction is effective and safe in alleviating clinical symptoms,reducing inflammatory responses,regulating immune function,and improving quality of life in children with HSP of the bleeding due to blood-heat pattern.
