I. Objective: To clarify that restoring the immune function of patients can eradicate allergic purpura. Allergic purpura is an allergic disease, also known as allergic reactive disease. It is a kind of allergic disease with small vasculitis as the main lesion and belongs to allergic reaction type III, also called immune complex type or vasculitis type. Allergic reactions are abnormalities of immune function. Allergic purpura, like other allergic diseases, is caused by the presence of three factors: genetic allergy, exposure to allergens, and abnormal immune function. If one of the three factors is not present, the disease will not occur. Genetic allergies cannot be solved and allergens are often difficult to avoid, but immune function can be restored to normal. Therefore, the key to the cause of the disease is that the immune function is not normal. If the immune function is restored to normal, the disease will not recur, and if the immune function continues to be normal, the disease will not recur. At present, domestic and foreign in the treatment of allergic purpura mostly use hormone or immunosuppressant, in fact, the efficacy is not ideal. Many patients are relapsing and slow to heal, and many of those who cannot be cured in other hospitals come to our department to be cured. The patients who used adrenal glucocorticosteroids before coming to our department are 7.8%, and they are mostly recurring in the reduction of hormone, and they have side effects of hormone such as round moon face and buffalo back.
II. Methods
1. Clinical data
1.1 600 cases were observed, 45.5% of men and 54.5% of women.
1.2 The minimum age was 70 days, the maximum age was 80 years, and 73% of the cases were ≤18 years old.
1.3 The duration of the disease ranged from 1 day to 20 years. From 4 months to 20 years for 45% of recurrent episodes.
1.4 There was a family history of allergy in 35.7%.
1.5 Comorbidities.
Purpura kidney 30%, intestinal bleeding 3%, cervical lymphatic tuberculosis 55%, mesenteric lymphatic tuberculosis 4%, recurrent colds 13%, allergic dermatitis 3%, chronic tonsillitis 3%, chronic pharyngitis 3%, urticaria 0.8%, chronic bronchitis 0.8%, eczema 0.7%, angioedema 0.5%, bronchial asthma 0.5%, recurrent mouth ulcers 0.5%, allergic rhinitis 0.3% .
1.6 Allergen detection 237 cases, of which more positive inhalation group are: mite 40%, late spring pollen 33%, early spring pollen 24.4%, summer and autumn pollen 24%, tobacco 23%, room dust 19%, mold II 16%, mold III 14.3%, mold I 13.9%, mosquito 13%. Food groups are: shrimp 5%, sea fish 3%, freshwater fish 3%, beef 2.5%, soybean 2.5%.
1.7 A total of 122 cases of erythrocyte immune function and regulatory factors were measured.
(1) Erythrocyte C3b receptor wreath rate 10.13±0.36 (normal value 16.2±2.7) p<0.001.
(2) Erythrocyte immune complex wreath rate 7.7±0.36 (normal value 4.8±4.12) p<0.001
(3) Erythrocyte immune C3b receptor wreath promotion rate 127.66±11.1 (normal value 189±28.3) p<0.001
(4) Erythrocyte immune C3b receptor wreath inhibition rate 41.97±0.31 (normal value 34.8±4.6) p<0.001
Allergic purpura erythrocyte immune function is not normal, there is a very significant difference in clinical significance.
2. Treatment of allergic purpura
2.1 Not rescue do not use hormones (prednisone, dexamethasone, hydrocodone, etc.), the condition is serious such as intestinal bleeding available, but in general do not use, because it will reduce the immune function, serious side effects, often in the reduction of discontinued and then to recurrent disease. In order to smoothly reduce or stop the hormone, we should add treatment to improve immune function, and add non-hormone temporary effective anti-allergic drugs, and if necessary, add as little oral dexamethasone as possible, in order to avoid the rebound aggravation of the disease when the hormone is stopped.
2.2 Quit and avoid smoking and alcohol, which reduce immune function, and quit smoking when someone in the family smokes, and passive smoking also suffers.
2.3 Chinese herbs Wu Wei Zi, Fang Feng, Chai Hu, Cicada, Astragalus, Licorice, Bai Mao Root, Forsythia, Xiao Ji, 10 grams of each of the above plus or minus 10 dates, decoction with water. Astragalus is used heavily for urine test with protein, and white foxglove, small thistle, motherwort, pu huang and artichoke are used heavily for urine test with red blood cells.
2.4 Dates about 20 per day, Anlao blood, rutin tablets, vitamin C.
2.5 Immune function improvement drugs: levamisole, inosine, cimetidine, lady’s mantle, astragalus, multi anti-methacin, etc. Allergens can be checked, but desensitization injections are generally not given in order to avoid more activities.
2.6 Bed rest and restriction of activities should be strict. Regular urine check (sent by family members for examination), regular follow-up by family members for medication. Diet temporarily do not eat the allergic food that actually triggers the disease, (allergy triggering will cease after immune function is restored) other foods can be eaten
2.7 Avoid emotional stress, overwork, and trauma, and treat diseases that impair immune function such as cervical lymphatic tuberculosis, which is often missed. Due to abnormal immune function, cervical lymphatic tuberculosis is often combined with cervical lymphatic tuberculosis (and individually with mesenteric and hilar lymphatic tuberculosis), but it is mostly underdiagnosed because cervical lymphatic tuberculosis symptoms are often hidden and incomplete, chest X-ray is negative, and tuberculin and tuberculosis antibodies are mostly negative when immune function is poor. Tuberculosis infection further reduces the immune function, and anti-tuberculosis treatment should be given at the same time for a good outcome. Allergic purpura is easily combined with purpura nephritis, and our department treats it with anti-tuberculosis treatment with berberine hydrochloride, which is effective. Berberine can anti-tuberculosis, also improve immune function, inhibit the increase of skin capillary permeability, anti-nephritis inhibit proteinuria
2.8 If necessary, temporary effective non-hormonal anti-allergic drugs such as paracetamol, cyproheptadine, ketotifen, reserpine, mindi, cetirizine, bactrim, petronectin, etc. can be added.
2.9 The recovery of immune function is relatively slow and the length of treatment varies from one person to another. According to the degree of good or bad immune function basis, the degree of seriousness of the disease, and the degree of treatment carefully and correctly, some 1 week can be relieved but attention should be paid to consolidation sometimes 1-2 years.
III. Results
1. Curative effect
According to the 134 cases of efficacy collected, 75% of the cases were statistically effective as a reference. However, from the fact that many patients with recurrent relapses treated with hormones (21 cases with a long duration of 3 months to 1 year, 22 cases with a duration of 1 to 5 years, 5 cases with a duration of 5 to 10 years, and 1 case with a duration of >10 years) have come to our department for treatment and have been cured, we can see that the treatment in our department is very effective indeed, and patients from overseas have been introduced to each other.
2. Case introduction
2.1 Purpura kidney, hormonal side effects
Medical record number: 4163, male, 22 years old, military
1998.12.16 initial diagnosis, the course of the disease 8 months. 1998.4.29 after returning from teaching in Yan’an thighs small red spots, no pain, extending to the limbs, buttocks, abdomen, platelets 119, urine RBC +, take Chinese medicine to see light, relapse, 1998.8.30 back to Beijing hospital, Demeter static point to 9.20 ineffective, change prednisone to November stop, change Chinese medicine 9.30 discharge, take Chinese medicine 1 month to see light, stomach discomfort, and stop. I was discharged from the hospital on 9.30, after taking Chinese herbal medicine for 1 month and seeing lightness and stomach discomfort. The side effects of hormones are garden moon face, buffalo back, weight 100 kg. After the visit, the urine protein (+) was checked and Huang Qi was reapplied, and the urine had red blood cells. Treated according to the above methods in our department. 2 months urine (-), no skin bleeding spots, no more offense
2.2 Allergic purpura kidney, artificial urticaria, urticaria, hormonal side effects, cervical lymphatic tuberculosis.
Medical record No. 4283, female, 19 years old, student, first diagnosed 1999.3.4, duration of disease 8 years, good season spring and autumn, the most severe in May-September. 1991.5 returned from school two lower extremities swollen, eyes swollen, head swollen into a bag, from the lower extremities to the whole body bleeding spots, bruises. In 1993.5, he was treated as before, but repeatedly, and was hospitalized for 5 times with dimethoate, prednisone, leucovorin and cyclophosphamide. Have garden moon face, buffalo back, hairy, purple lines, menopause for 8 months, lack of. Since 1993.11.18 urine protein (++++), (protein 5 g) and repeated. 1993 gastrointestinal bleeding, night deficiency resuscitation. He used hormones repeatedly and was afraid to open the windows and go out every spring, summer and autumn from May to December, but he had to be hospitalized as soon as he went out and had to spend tens of thousands of yuan on allergies. 1995 Tonsils were large and removed. 1995 Four Medical University tested allergens (-) and desensitizing solution for 2 months. In Beijing, Henan and Union Medical College, the treatment was ineffective. 1997 and 1998, only 100 sticks of Ben were ineffective. Personal allergy history: tetracycline allergy, redness, swelling and itching in the pubic area. Checked two cervical lymph nodes, soybean size, light pressure pain.
He came to our clinic and was treated according to our protocol: gradually healed. 1999.7.2 Occasional bleeding spots, urine protein (±), better than last year. 2000.8.26 Chinese medicine changed to purpura capsule. 2001.6.15 Several bleeding spots on upper limbs after day fever. 2001.9.4 No recurrence, urine protein (-) since 2001.5. 2002.3.5 Skin test summer and autumn pollen (+), Artemisia pollen ( +++), erythrocyte immunoassay has progressed. Open window is not offensive, check cervical lymph nodes are not reached, immunity is seen to be good. Treatment tapered, 2002.7.26 rechecked good. 2005.10.25 rechecked still effective, has graduated from technical school work.
IV. Conclusion
The key to the cause of allergic purpura is abnormal immune function. Restoring the immune function can achieve the root cause. The important development future of immunotherapy (including Chinese medicine)
The current academic authority on allergic reactions in China, Professor Ye Shitai, suggested in the chapter of “Practical Allergology” on the principles and methods of prevention and treatment that in recent years the allergist community is considering non-specific means of prevention and treatment to change the problem of human allergy. For example, in our ancestral medicine, the Chinese medicine “Allergy Decoction” has been very effective in allergic diseases. In Western medicine, various non-specific immunotherapy treatments such as histamine desensitization and histamine globulin injection have achieved certain clinical efficacy in recent years, which will open up a brand new path in the prevention and treatment of allergic diseases in the future. Some scholars predict that in the 21st century, drugs regulating immune function will become an important class of drugs and replace other drugs. Chinese medicine is an important treasure for immunotherapy, and the experience of this paper also confirms the above argument.