Clinical study of the Liangxue-Zhuyu decoction combined with montelukast in the treatment of henoch schonlein purpura

Abstract

Objective To study the efficacy of Liangxue-Zhuyu decoction combined with montelukast in the treatment of henoch schonlein purpura (HSP) and its influence on immunologic function. Methods A total of 95 HSP children treated in department of pediatrics from February 2014 to December 2016 were enrolled, and then were randomly divided into observation group (n=48) and control group (n=47), meanwhile another 48 healthy children admitted to a medical examination were selected as the healthy group. The patients in the control group were given the treatment of oral montelukast sodium chewable tablets before sleeping (the dose:2-6 years old 4 mg/d, 6-14 years old 5 mg/d), and the patients in the observation group accepted the therapy of Liangxue-Zhuyu decoction based on the treatment of the control group. The course of the treatment in the two groups were 30d. The time of clinical symptom regression and adverse reactions were recorded, and the clinical efficacy was evaluated. Monoclonal antibody immunofluorescence method and Enzyme-linked immunosorbent assay (ELISA) were used to detect the levels of serum T lymphocyte subsets and INF-γ and IL-10 before and after treatment, and their differences among three groups were compared. Results The effective rates of the observation group was 95.8% (46/48), which was significantly higher than 76.6% (36/47) of control group (χ2=7.441, P<0.05). The subsided time of the symptoms, including purpura (5.0 ± 1.3 d vs. 6.6 ± 2.6 d, t=3.816), abdominal pain (3.1 ± 2.1 d vs. 4.1 ± 2.6 d, t=2.139), joint pain (4.3 ± 1.5 d vs. 5.4 ± 1.9 d, t=3.416), fecal occult blood (4.5 ± 1.5 d vs. 6.1 ± 1.9 d, t=4.404) of the observation group were significantly shorter than those of the control group (P<0.05). After the treatment, the CD4 (45.14% ± 9.32% vs. 41.02% ± 9.97%), CD8 (25.10% ± 4.69% vs. 21.52% ± 5.71%) of the observation group was significantly higher than those of the control group, and the CD4/CD8 (1.62 ± 0.32 vs. 1.95 ± 0.35) and IL-10 (33.07 ± 1.86 pg/ml vs. 53.92 ± 2.98 pg/ml) of the observation group was significantly lower than this of the control group (P<0.05). Conclusions The efficacy of the Liangxue-Zhuyu decoction combined with montelukast for HSP was definite, and the effect was rapid with little side effects. The mechanism might be related to regulating the secretion of T lymphocyte and IL-10, thereby to correct Th1/Th2 cell balance and disturbance of immune function. Key words: Purpura, schoenlein-henoch; Liangxue-Zhuyu decoction; Montelukast sodium chewable tablets; T-Lymphocytes; Interferon-gamma; Interleukin-10