Henoch-Schönlein purpura is a systemic vascular disease due to allergic reactions to certain substances in arterioles and capillaries, causing increased vascular wall permeability and exudative bleeding and edema. Clinically, skin purpura is the most common, which can be accompanied by abdominal pain, wandering muscle and joint swelling, urine occult blood, protein positive, etc., and is clinically divided into simple skin type, joint type, abdominal type, renal type and mixed type. Professor Shi Shurong said that the disease is more common in children and adolescents, and there are slightly more men than women. The causes can be roughly summarized as infections (bacteria, viruses, etc.), food (fish, shrimp, crabs, etc.), drugs (penicillin, sulfonamides, etc.) and others (pollen, insect bites, cold, emotions, vaccinations, etc.), of which bacterial or viral infections are more common, and most cases often have a history of upper respiratory tract infections 1 to 3 weeks before the onset of the disease. This disease is equivalent to the category of "blood certificate (purple spots, blood in the urine), muscle worm, grape disease" in Traditional Chinese medicine.
1. Clinical manifestations
1. Skin manifestations: the occurrence of maculopapular purpura of different sizes near the large joints of the lower limbs and the buttocks, a small number of surfaces and trunks, initial skin itching, urticaria, angioedema, erythema multiforme, erythema nodules, etc., with severe skin lesions, local formation of blood vesicles, and even rupture and necrosis.
2. Gastrointestinal manifestations: paroxysmal abdominal cramps or persistent dull pain, which can be accompanied by vomiting, blood in the stool (bloody stool in severe cases), and even complications such as intestinal obstruction and intussusception.
3. Joint manifestations: wandering muscles and joints are swollen and painful, mostly occurring in the knee and ankle joints, single or multiple, and the joint cavity may have exudate, leaving no sequelae.
4. Renal manifestations: gross hematuria or microscopic hematuria and proteinuria appear at the beginning of the onset of the disease or about 2 to 4 weeks of purpura, and can also appear after purpura subsides or the quiescent period of the disease.
5. Other symptoms (rare): intracranial hemorrhage leading to coma and convulsions.
2. Disease treatment
1. Western medicine treatment: 1. Clear the cause. 2. Antihistamine drugs: such as loratadine, chlorpheniramine, calcium gluconate. 3. Glucocorticoids. 4. Reduce vascular permeability: vitamin C, rutin. 5. Inhibitors of platelet aggregation: Pansontin. 6. Others: cyclophosphamide, intravenous gamma globulin, plasma exchange, etc.
2. TCM dialectical treatment
Chinese medicine believes that the disease is intolerant, external sense of evil qi, the cause is mostly related to wind, humidity, heat, stasis, and false evil, and it is generally divided into 3 types.
1, hot poison blazing evidence, and wind and evil
Symptoms: Skin bleeding points are mainly on the skin above the chest and back, upper limbs, and knee joints, with a symmetrical distribution of bright red color, dry mouth likes cold drinks, heat intolerance, red tongue, thin yellow moss, and pulse number.
Treatment: clear heat and detoxification, cool blood and activate blood and dispel wind.
Prescription medicine: Rhinoceros dihuang soup is mainly added or subtracted.
2. Damp heat connotation, concurrent wind
Symptoms: skin bleeding points, based on both lower limbs, bright red, symmetrical distribution, can be accompanied by skin ulceration bleeding points, dark red tongue, thick yellow moss, pulse slip number.
Treatment: clear heat, dry and wet, cool blood and blood dispel wind.
Prescription medicine: Simiao soup plus or minus.
3. Qi deficiency and blood stasis
Symptoms: the disease does not heal for a long time, repeated attacks, movement is aggravated, skin bleeding points are based on the skin below the knees, the bleeding spots are reddish, the regression is slow, the tongue is dull, the moss is thin and white, and the pulse is thin and slow.
Treatment: Beneficial qi and invigorating blood.
Prescription medicine: tonic and beneficial qi soup plus or minus.
4. Addition and subtraction of drugs: with joint muscle swelling and pain, plus prevention, Qin Gang, Sea Breeze Vine, Welling Immortal, etc.; Accompanied by skin itching, add white fresh skin, ground skin, windproof, bitter ginseng, duckweed and so on.
Abdominal type
Symptoms: Clinically, in addition to purpura, paroxysmal periumbilical pain is the mainstay, sometimes nausea, vomiting, vomit as gastric contents, or accompanied by blood capillary, fatigue and fatigue, dullness, dark redness, thick moss slightly yellow, fine veins.
Manifestation: Spleen deficiency and wet stasis connotation.
Treatment: healthy spleen dry and wet, invigorating blood and relieving pain.
Prescription medicine: Cangshu, Wumei, fried white peony, burning licorice, Yuanhu, Muxiang, fried Pu Huang, Wuling Fat, etc.
Other Featured Treatments:
1. For skin-type purpura, oral combination of traditional Chinese medicine combined with external application and washing of traditional Chinese medicine shortens the course of treatment and reduces the recurrence rate;
2. For abdominal purpura, the treatment of traditional Chinese medicine colon drip and Traditional Chinese medicine patch shen que acupuncture was carried out, which significantly reduced the incidence of intestinal obstruction, intussusception and gastrointestinal bleeding, and shortened the time of abdominal pain.
3. Disease protection
1. Bed rest at the beginning of the disease, avoid fatigue, gradually increase the amount of activity to return to normal after the condition is relatively stable, enhance physical fitness, and improve the body's ability to resist diseases;
2. Pay attention to diet, avoid spicy and irritating foods, or small foods and other foods with additives, and gradually eat meat, eggs, milk, seafood and other foods under the guidance of a doctor;
3. Pay attention to keep warm, prevent colds, try not to use antipyretic and analgesic drugs when you have a cold, and choose sensitive antibiotics when there is a clear infection or infection foci;
4. Avoid emotional fluctuations and mental stimulation, avoid insect and animal bites, and remove possible allergens;
5. The key to preventing and treating allergic diseases is not to block allergens from entering the body, but to truly eliminate the harm of allergic diseases to people by improving and correcting allergic constitutions and regulating the body's immune function.