Safety and Efficacy Evaluation of Traditional Chinese Medicine (Qingre‐Lishi‐Yishen Formula) Based on Treatment of Regular Glucocorticoid Combined with Cyclophosphamide Pulse in Children Suffered from Moderately Severe Henoch–Schonlein Purpura Nephritis with Nephrotic Proteinuria

Abstract

Objective. At present, the most appropriate management of Henoch–Schonlein purpura nephritis (HSPN) with nephrotic-range proteinuria still remains controversial; thus, the purpose of this study is to evaluate safety and efficacy of traditional Chinese medicine (TCM), Qingre-Lishi-Yishen Formula (QLYF), integrated with regular oral glucocorticoid and cyclophosphamide intravenous pulse therapeutic regimen in children suffered from moderately severe HSPN with nephrotic proteinuria. Methods. From 1 January 2012, to 1 January 2016, totally 150 hospitalized children suffered from HSPN with nephrotic proteinuria were included. All were treated with glucocorticoid and cyclophosphamide, and 100 of them were treated with integrative traditional Chinese decoction QLYF. Patients were followed up for 2 years. Rate of adverse event occurrence, short-term clinical effects, long-term clinical effects, and TCM therapeutic evaluation were all compared. Results. Total adverse event rate was lower in the QLYF group (χ2 = 5.357, p=0.022); rates of respiratory infection, urinary infection, poor appetite, hepatotoxity, cardiotoxicity, and neutropenia were all decreased in patients who received QLYF (p<0.05), and no cases of hepatic and renal toxicities related to the herbal medicine were observed in the QLYF group. For short-term clinical efficacy evaluation, lower levels of 24 hour proteinuria (p<0.05) and urine blood cell count (p<0.05) were found in the QLYF group. For long-term efficacy evaluation, better clinical control rate effective rate, lower recurrence rate (p<0.05), and fewer TCM syndrome score (p<0.05) were found in the QLYF group. Conclusion. Compared with merely using regular oral glucocorticoid plus cyclophosphamide pulse therapeutic regimen, the therapeutic regimen that integrates QLYF with the abovementioned western medicine might be a safe means to decrease the occurrence rate of adverse events and improve short-term and long-term clinical effects in children who suffered from moderately severe HSPN with nephrotic proteinuria.

Study on the clinical mechanism of Tong-Xie-An-Chang Decoction in the treatment of diarrheal irritable bowel syndrome based on single-cell sequencing technology

“…At present, more attention has been focused on Traditional Chinese Medicine (TCM) with its well-defined and established therapeutic system. [ 23 ] TCM, with traditional Chinese syndrome differentiation as the core, has a stable effect in the treatment of IBS-D. Tong-Xie-An-Chang Decoction (TXACD), created by professor Jun-xiang Li from Dongfang Hospital, Beijing University of Chinese Medicine, has been shown to be effective in relieving abdominal pain in IBS-D patients in our previous randomized positive controlled clinical trial. [ 15 ] Simultaneously, in IBS-D experimental rat model, TXACD was proved that it could reduce the fecal water content and abdominal withdrawal reflex (AWR) score, used to evaluate visceral sensitivity.…”

Influence of transitional nursing on the compliance behavior and disease knowledge of children with purpura nephritis

“…Henoch-Schönlein purpura nephritis is a common disease in children[ 8 - 10 ]. Clinical studies have shown that the disease is an allergic reaction caused by bacteria, such as Legionella or Salmonella, viruses such as rubella virus or varicella virus, parasites such as roundworm and Mycoplasma, etc.…”

Proanthocyanidins: A novel approach to Henoch‑Schonlein purpura through balancing immunity and arresting oxidative stress via TLR4/MyD88/NF‑κB signaling pathway (Review)

“…Despite conventional medications to control HSP, such as anti-inflammatory drugs, corticosteroids, cytotoxic drugs and immunosuppressants ( 8 , 127 , 128 ). These measures are unsuitable for long-term use due to the high cost, transient efficacy and severe adverse effects, like long-term and large-scale use of glucocorticoids could cause infections and Cushing's syndrome; long-term use of cytotoxic drugs that could result in gastrointestinal reactions, hepatotoxicity, bone marrow suppression, reproductive toxicity, cardiotoxicity ( 12 ). Proanthocyanidins, as natural extracts from plants, have widespread sources and diverse bioactivity with minimal side effects and can be used by pregnant people ( 118 ).…”

“…However, these therapies exhibit poor efficacy and do not stop recurrence, research has shown that relapses occur in about 25% of patients and that children over age 8 or those with kidney-based disease are more prone to relapse ( 11 ); furthermore, most approaches to HSP are unsuitable for long-term application owing to high expenditures and adverse side effects, e.g. long-term and large-scale use of glucocorticoids could cause infections and Cushing's syndrome; long-term use of cytotoxic drugs that could result in gastrointestinal reactions, hepatotoxicity, bone marrow suppression, reproductive toxicity, cardiotoxicity ( 12 ). Thus, a novel and effective cure for HSP is required.…”