探讨过敏性紫癜(HSP)患儿中医辨证施治治疗前、后血清白三烯B4(LTB-4)及白细胞介素6(IL-6)含量变化及其临床意义。

选择2012年1月至2014年12月，于成都中医药大学附属医院儿科门诊确诊并治疗的70例HSP患儿为研究对象，纳入HSP组，其中中医辨证分型为血热妄行型为45例、气不摄血型为25例。将同期于本院门诊体检的20例健康儿童纳入对照组。采用酶联免疫吸附测定(ELISA)法，检测两组儿童血清LTB-4及IL-6含量。将HSP组患儿治疗前与治疗后的血清LTB-4及IL-6含量进行统计学比较，并分别与对照组儿童进行统计学比较；同时比较2种中医辨证分型HSP患儿治疗后血清LTB-4、IL-6含量下降值差异及病情反复率、肾脏损害率差异。两组儿童年龄及性别构成比比较，差异无统计学意义(P>0.05)。本研究遵循的程序符合成都中医药大学附属医院伦理审查委员会制定的伦理学标准，得到该委员会批准，征得受试对象监护人知情同意，并与之签署临床研究知情同意书。

①HSP组患儿治疗前LTB-4及IL-6含量[(114.7±6.3) ng/L、(286.9±64.1) ng/L]，均较对照组[(18.5±0.5) ng/L、(35.4±3.5) ng/L]或HSP组患儿治疗后[(18.2±1.9) ng/L、(34.9±2.3) ng/L]高，且差异均有统计学意义(t＝－6.794、－6.794，P<0.05；t＝－7.271、－7.271，P<0.05)。②治疗后血热妄行型HSP患儿血清LTB-4、IL-6含量下降值[(100.7±4.0) ng/L、(288.5±43.3) ng/L]，均较气不摄血型含量下降值[(94.2±6.3) ng/L、(186.0±35.5) ng/L]多，且差异有统计学意义(t＝5.23、－10.10，P<0.05)；而气不摄血型HSP患儿病情反复率及肾脏损害率(40.0%、20.0%)，均较血热妄行型(15.6%、2.2%)者高，且差异有统计学意义(χ²＝5.22、6.48，P<0.05)。

中医辨证施治对HSP患儿血清LTB-4及IL-6含量有调节作用。气不摄血型HSP患儿病情易反复，并且容易发生肾脏损害。

To observe the contents changes and the clinical significance of both serum leukotriene B4(LTB-4) and interleukin 6(IL-6) of children with Henoch-Schonlein purpura(HSP) after treatment determine based on traditional Chinese medicine(TCM) differentiation of symptoms and signs.

From January 2012 to December 2014, a total of 70 HSP children who were diagnosed and treated in pediatric out-patient department in Teaching Hospital of Chengdu University of Traditional Chinese Medicine, were chosen as study objects and including in HSP group, while 45 of them were diagnosed as TCM syndrome type of"hemopyretic bleeding", and 25 of them were diagnosed as"qi falling to control blood". Meanwhile, another 20 healthy children who were taken health examinations in out-patient department at the same time in the same hospital were including in control group.Enzyme-linked immunosorbent assay(ELISA) method was used to detect the contents of both serum LTB-4 and IL-6 in two groups. Compared differences of serum contents of LTB-4 and IL-6 of following: between before treatment and after treatment in HSP group, between HSP group before treatment or HSP group after treatment and control group, respectively; also compared the descending values of serum contents of LTB-4 and IL-6 after treatments, disease repeated rates and kidney injury rates between two TCM syndrome types of HSP children by statistical methods. There were no significant differences between two groups in age and gander constituent ratios(P>0.05). The study protocol was approved by the Ethical Review Board of Investigation in Human Being of Teaching Hospital of Chengdu University of Traditional Chinese Medicine. Informed consent was obtained from the parents of each participant.

①Contents of serum LTB-4 and IL-6 in HSP group before treatment[(114.7±6.3) ng/L, (286.9±64.1) ng/L] were higher than those of control group[(18.5±0.5) ng/L, (35.4±3.5) ng/L], or those of HSP group after treatment[(18.2±1.9) ng/L, (34.9±2.3) ng/L], and all the differences above were statistically significant (t=-6.794, -6.794; P<0.05.t=-7.271, -7.271; P<0.05). ②Descending values of contents of serum LTB-4 and IL-6 after treatments of"hemopyretic bleeding"HSP children[(100.7±4.0) ng/L, (288.5±43.3) ng/L] were more than those of"qi falling to control blood"HSP children [(94.2±6.3) ng/L, (186.0±35.5) ng/L], and the differences were statistically significant(t=5.23, -10.10; P<0.05). But, the disease repeated rates and kidney injury rates of"qi falling to control blood"HSP children(40.0%, 20.0%) were higher than those of"hemopyretic bleeding"HSP children(15.6%, 2.2%), and the differences were statistically significant (χ²=5.22, 6.48; P<0.05).

Determine treatment based on TCM differentiation of symptoms and signs has modifying effects on contents of serum LTB-4 and IL-6 in children with HSP.There is more possibility for"qi falling to control blood"HSP children to get disease repeat and kidney injury.