Study on the difficulties of IgA vasculitis in clinical treatment and the treatment methods of Chinese medicine and integration of traditional and western medicine

  • role: First author第一作者
  • Affiliation:

    Department of Hematology, First Affiliated Hospital, Heilongjiang University of Chinese Medicine, Harbin 150040, China

  • Introduction:
WANG Jinhuan1,  
  • Affiliation:

    Heilongjiang University of Chinese Medicine, Harbin 150006, China

SHI Wenxuan2,  
  • role: Corresponding author通信作者
  • Affiliation:

    Department of Hematology, First Affiliated Hospital, Heilongjiang University of Chinese Medicine, Harbin 150040, China

  • Email:weizhengsun@163.com
  • Introduction:Prof.SUN Weizheng, Chief Physician, Doctoral Supervisor. Department of Hematology, The First Affiliated Hospital of Heilongjiang University of Chinese Medicine, 26 Heping Road, Xiangfang District, Harbin 150040. E-mail: weizhengsun@163.com
SUN Weizheng1*

résumé

Through the analysis of relevant literatures, the characteristics and advantages of traditional Chinese medicine (TCM) and Western medicine in the clinical treatment of IgA vasculitis are reviewed. Studies published between January 1, 2012, and November 10, 2022, were retrieved from the China National Knowledge Infrastructure database and the PubMed database to summarize and evaluate the key challenges in the clinical treatment of IgA vasculitis: recurrent and not easy to cure, gastrointestinal symptoms which are difficult to resolve, inevitable and protracted kidney damage. With improvement in IgA vasculitis treatment, these key difficulties have become urgent problems. TCM has unique advantages in the treatment of this disease, but there are still major problems in TCM-based treatment: the lack of guidelines for diagnosis and treatment of IgA vasculitis in adults and children, hormone use norms, and high-quality clinical studies. This article discusses the clinical treatment of IgA vasculitis based on either TCM alone or integrated traditional Chinese and western medicine to further improve the clinical treatment of this disease.

mots-clés

IgA vasculitis;recurrence;abdominal;nephritis;treatment

References

  1. [1].
    SUNDERKOTTER CH, ZELGER B, CHEN KR, et al. Nomenclature of Cutaneous Vasculitis: Dermatologic Addendum to the 2012 Revised International Chapel Hill Consensus Conference Nomenclature of Vasculitides[J]. Arthritis Rheumatol, 2018,70(2): 171-184.
  2. [2].
    PILLEBOUT E, SUNDERKOTTER C. IgA vasculitis[J]. Semin Immunopathol, 2021,43(5): 729-738.
  3. [3].
    XU L, LI Y, WU X. IgA vasculitis update: Epidemiology, pathogenesis, and biomarkers[J/OL]. Front Immunol,2022,13:921864[2022-11-10]..
  4. [4].
    NOSSENT J, RAYMOND W, ISOBEL KH, et al. Morbidity and mortality in adult-onset IgA vasculitis: a long-term population-based cohort study[J]. Rheumatology (Oxford), 2021,61(1): 291-298.
  5. [5].
    OZEN S, MARKS SD, BROGAN P, et al. European consensus-based recommendations for diagnosis and treatment of immunoglobulin A vasculitis-the SHARE initiative[J]. Rheumatology (Oxford), 2019,58(9): 1607-1616.
  6. [6].
    中华中医药学会. 过敏性紫癜[J]. 风湿病与关节炎,2012,1(5): 75-78.
  7. [7].
    傅桐,杜悦. 儿童IgA血管炎诊断与治疗[J]. 中国实用儿科杂志,2022,37(1): 17-21.
  8. [8].
    ROMAN C, DIMA B, MUYSHONT L, et al. Indications and efficiency of dapsone in IgA vasculitis (Henoch-Schon-lein purpura): case series and a review of the literature[J]. Eur J Pediatr, 2019,178(8): 1275-1281.
  9. [9].
    FENOGLIO R, NARETTO C, BASOLO B, et al. Ritux-imab therapy for IgA-vasculitis with nephritis: a case series and review of the literature[J]. Immunol Res, 2017,65 (1): 186-192.
  10. [10].
    CRAYNE CB, ELOSEILY E, MANNION ML, et al. Rit-uximab treatment for chronic steroid-dependent Henoch-Schonlein purpura: 8 cases and a review of the literature[J]. Pediatr Rheumatol Online J, 2018,16(1): 71[2022-10-15]. .
  11. [11].
    CALVO-RIO V, HERNANDEZ J L, ORTIZ-SANJUAN F, et al. Relapses in patients with Henoch-Schonlein purpura: Analysis of 417 patients from a single center[J/OL]. Medicine (Baltimore),2016,95(28):e4217[2022-11-10]..
  12. [12].
    LEI WT, TSAI PL, CHU SH, et al. Incidence and risk factors for recurrent Henoch-Schönlein purpura in children from a 16-year nationwide database[J]. Pediatr Rheumatol Online J, 2018,16(1): 25[2022-10-15]. .
  13. [13].
    ZHOU J, LI L, LUO J, et al. Association between common laboratory indices and IgAV recurrence in children[J]. BMC Pediatr, 2022,22(1):606[2022-10-17]. .
  14. [14].
    黄永辉. 幽门螺杆菌感染与复发性过敏性紫癜的关系[J]. 中国实用医药,2017,12(13): 14-16.
  15. [15].
    张淼,杨燕,赵骞. 青紫合剂治疗儿童热毒血瘀型过敏性紫癜的临床疗效观察[J]. 中华中医药杂志,2019,34(4): 1822-1824.
  16. [16].
    齐海花,黄占强,何磊,等. 玉屏风颗粒对过敏性紫癜患者外周血Th1/Th2型细胞因子的影响及预防复发作用[J]. 中国中西医结合皮肤性病学杂志,2020,19(3): 241-243.
  17. [17].
    何松蔚,王俊宏,赵骞,等. 清热利湿、活血解毒中药治疗儿童过敏性紫癜临床疗效观察及复发特点分析[J]. 中医药学报,2021,49(4): 47-53.
  18. [18].
    罗卓夫,何渊民,许飏. Lp-PLA2、NLR及CRP对成人过敏性紫癜复发的预测价值[J]. 标记免疫分析与临床,2020,27(6): 1001-1005.
  19. [19].
    彭海丽. 过敏性紫癜近六年临床特征变化及合并消化道出血危险因素分析[D]. 南昌:南昌大学,2020.
  20. [20].
    马鹏飞,储婧,龙云,等. 腹型过敏性紫癜内窥镜检查及病理学特点[J]. 安徽医学,2021,42(2): 132-135.
  21. [21].
    LOUIE C Y, GOMEZ A J, SIBLEY R K, et al. Histologic Features of Gastrointestinal Tract Biopsies in IgA Vasculitis (Henoch-Schönlein Purpura)[J]. Am J Surg Pathol, 2018,42(4):529-533.
  22. [22].
    李婧,高成龙,吴捷. 以腹型为首发表现的儿童过敏性紫癜临床分析[J]. 中国实用儿科杂志,2021,36(1): 47-52.
  23. [23].
    GUO QY, HU XL, SONG CD, et al. Clinical characteristics and associating risk factors of gastrointestinal perforation in children with IgA vasculitis[J]. Ann Med, 2021,53(1): 2315-2320.
  24. [24].
    梁庆红,王烨,张莹,等. 过敏性紫癜儿童肠黏膜屏障与Treg/Th17作用关系的研究[J]. 中国微生态学杂志,2015,27(9): 1022-1026.
  25. [25].
    张婷婷,吉晓菲,李少遊,等. 过敏性紫癜患儿Th17、Treg细胞及IL-17、IL-23水平的测定[J]. 中国免疫学杂志,2016,32(12): 1801-1804.
  26. [26].
    金欣,黄建玲,黄智敏,等. 幽门螺杆菌与腹型过敏性紫癜胃肠道黏膜损害程度的关系研究[J]. 现代消化及介入诊疗,2020,25(12): 1652-1654.
  27. [27].
    SONG ZX, NIE YL, YANG L, et al. Predicting Severe Renal and Gastrointestinal Involvement in Childhood Immunoglobulin A Vasculitis with Routine Laboratory Parameters[J]. Dermatology, 2022,238(4):745-752.
  28. [28].
    董德明,翟敏,廖廷彦. 腹型过敏性紫癜患儿血清IFN-γ、IL-4、I-FABP水平及临床意义[J]. 国际检验医学杂志,2021,42(18): 2186-2189.
  29. [29].
    Hocevar A, Tomsic M, Jurcic V, et al. Predicting gastrointestinal and renal involvement in adult IgA vasculitis[J]. Arthritis Res Ther, 2019,21(1):302[2022-10-17]. .
  30. [30].
    梁晓红,罗文辉,刘雅妍,等. 清热利湿活血解毒汤联合西药治疗腹型过敏性紫癜湿毒内蕴证疗效观察[J]. 现代中西医结合杂志,2021,30(15): 1674-1677.
  31. [31].
    杨燕,盛燕,张克青,等. 清热利湿活血解毒中药联合西药治疗腹型过敏性紫癜湿毒内蕴证75例临床观察[J]. 中医杂志,2016,57(9): 763-766.
  32. [32].
    中华医学会儿科学分会肾脏学组. 紫癜性肾炎诊治循证指南(2016)[J]. 中华儿科杂志,2017,55(9): 647-651.
  33. [33].
    李小艳,祝红兴,邢海燕. 从肝脾肾论治过敏性紫癜性肾炎[J]. 河南中医,2020,40(6): 847-849.
  34. [34].
    CLAVE S, SORDET M, TSIMARATOS M, et al. Association of kidney biopsy findings with short- and medium-term outcomes in children with moderate-to-severe IgA vasculitis nephritis[J]. Eur J Pediatr, 2021,180(10):3209-3218.
  35. [35].
    VAN dE PERRE E, JONES R B, Jayne D. IgA vasculitis (Henoch-Schönlein purpura): refractory and relapsing disease course in the adult population[J]. Clin Kidney J, 2021,14(8):1953-1960.
  36. [36].
    JELUSIC M, SESTAN M, CIMAZ R, et al. Different histological classifications for Henoch-Schönlein purpura nephritis: which one should be used[J]. Pediatr Rheumatol Online J, 2019,17(1): 10[2022-10-17]..
  37. [37].
    SUZUKI H, MOLDOVEANU Z, JULIAN BA, et al. Autoantibodies Specific for Galactose-Deficient IgA1 in IgA Vasculitis With Nephritis[J]. Kidney Int Rep, 2019,4(12): 1717-1724.
  38. [38].
    HASTINGS MC, RIZK DV, KIRYLUK K, et al. IgA vasculitis with nephritis: update of pathogenesis with clinical implications[J]. Pediatr Nephrol, 2022,37(4): 719-733.
  39. [39].
    徐梅秀,薛丕良,王冬梅,等. 养元护肾消癜方治疗过敏性紫癜肾炎急性期的疗效及对微循环指标、血清sICAM-1、sVCAM-1、IL-33、IL-8的影响[J]. 中国中医急症,2021,30(4): 626-628.
  40. [40].
    袁凯,熊小丽,程静,等. 肝肾同治法联合西药治疗小儿过敏性紫癜性肾炎临床研究[J]. 湖北中医药大学学报,2019,21(3): 73-76.
  41. [41].
    张少卿,张君,王绍洁,等. 紫丹颗粒早期干预过敏性紫癜患儿的临床疗效及其对患儿肾损害的影响研究[J]. 中国煤炭工业医学杂志,2016,19(2): 217-220.
  42. [42].
    ONI L, SAMPATH S. Childhood IgA Vasculitis (Henoch Schonlein Purpura)-Advances and Knowledge Gaps[J]. Front Pediatr, 2019,7: 257[2022-10-17]..
  43. [43].
    YANG X, LI Q, HE Y, et al. Individualized medication based on pharmacogenomics and treatment progress in children with IgAV nephritis[J]. Front Pharmacol, 2022,13:956397[2022-10-17]..

Lire l'article complet

The above content is generated by Large Model Translation. The translated content is for reference only. We do not assume any commercial or legal responsibilty for any consequences arising from the use of our website