内科

目的探讨玉屏风散联合孟鲁司特治疗过敏性紫癜（HSP）患儿的疗效及安全性。方法采用随机对照设计，选取2023年1月至2024年12月项城市卫校中西医结合医院收治的80例HSP患儿为研究对象，采用随机数字表法将其分为对照组与研究组，每组40例。对照组患儿接受孟鲁司特治疗，研究组接受玉屏风散联合孟鲁司特治疗，两组均持续治疗3个月。比较两组患儿的症状改善情况、不良反应发生情况及治疗前后的血清学指标［白细胞介素（IL）-6、IL-21、超氧化物歧化酶（SOD）、丙二醛（MDA）］、T淋巴细胞亚群［辅助性T细胞（Th17）比例、调节性T细胞（Treg）比例、Th17/Treg比值］。结果研究组患儿皮肤紫癜、关节症状、腹部表现消退及肾脏损害恢复所需时间均短于对照组（均P<0.05）。治疗前，两组血清IL-6、IL-21、SOD、MDA水平，Th17、Treg比例，以及Th17/Treg比值差异均无统计学意义（均P>0.05）。治疗3个月后，两组血清IL-6水平、血清MDA水平、Th17比例及Th17/Treg比值均较治疗前下降，血清IL-21、SOD水平及Treg比例均较治疗前升高（均P<0.05）；研究组血清IL-6水平、血清MDA水平、Th17比例及Th17/Treg比值均低于对照组，血清IL-21、SOD水平及Treg比例均高于对照组（均P<0.05）。研究组不良反应总发生率为12.50%，与对照组的7.50%比较，差异无统计学意义（P>0.05）。结论玉屏风散联合孟鲁司特治疗HSP患儿可获得较理想的治疗效果，能缩短症状消退所需时间，减轻炎症及氧化应激反应，改善机体免疫平衡，且安全性较好。

Objective To explore the efficacy and safety of Yupingfeng Powder combined with montelukast in the treatment of children with Henoch-Schönlein purpura (HSP). Methods A randomized controlled trial was conducted. A total of 80 children with HSP admitted to the Integrated Traditional Chinese and Western Medicine Hospital of Xiangcheng Health School from January 2023 to December 2024 were enrolled as research subjects, and they were divided into a control group or a study group by random number table method, with 40 cases in each group. The control group was treated with montelukast alone, while the study group received combined therapy of Yupingfeng Powder and montelukast. Both groups were treated continuously for 3 months. The symptom improvement; serological indicators (interleukin [IL]-6, IL-21, superoxide dismutase [SOD], and malondialdehyde [MDA]) and T lymphocyte subsets (helper T cell [Th17] proportion, regulatory T cell [Treg] proportion, and Th17/Treg ratio) before and after treatment; and the incidence of adverse reactions were compared between the two groups. Results The time to resolution of skin purpura, joint symptoms, and abdominal manifestations and time to the recovery of renal damage in the study group were shorter than those in the control group (all P<0.05). Before treatment, there was no statistically significant difference in serum level of IL-6, IL-21, SOD, or MDA, proportion of Th17 or Treg, or Th17/Treg ratio between the two groups (all P>0.05). After 3 months of treatment, serum IL-6 and MDA levels, Th17 proportion, and Th17/Treg ratio in both groups decreased, while serum IL-21 and SOD levels and Treg proportion increased compared with baseline (all P<0.05); the study group had lower serum IL-6 and MDA levels, Th17 proportion, and Th17/Treg ratio, and higher serum IL-21 and SOD levels and Treg proportion than the control group (all P<0.05). The total incidence of adverse reactions was 12.50% in the study group, compared with 7.50% in the control group, showing no statistically significant difference (P>0.05). Conclusion Yupingfeng Powder combined with montelukast achieves satisfactory therapeutic effects in children with HSP, and it can shorten the time of symptom remission, alleviate inflammatory response and oxidative stress, improve immune balance, and maintain good safety profile.