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Received Jan 12, 2018; Accepted Mar 12, 2018
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1. Background
Henoch-Schönlein purpura nephritis is a systemic disorder characterized by leukocytoclastic vasculitis involving the capillaries and the deposition of IgA immune complexes. Renal involvement is the principal cause of morbidity and mortality in children with HSP [1, 2]. Approximately 40% of children with HSP develop nephritis, usually within 4 to 6 weeks after the initial onset of the typical purpuric rashes. Although the pathogenetic mechanisms are still not fully delineated, several studies suggested that galactose-deficient IgA1 (Gd-IgA1) is recognized by anti-glycan antibodies, leading to the formation of the circulating immune complexes and their mesangial deposition which induce renal injury in HSPN [3–6]. As to the pathogenesis, several studies suggested that the severity of renal involvement is the major factor determining the long-term outcome of children with HSPN.
Aggressive therapies for the treatment of severe HSPN, including multiple drug combination therapy and plasmapheresis, have been shown to be effective in ameliorating proteinuria and histological severity. There is no clear consensus as to which patients with Henoch-Schönlein purpura nephritis (HSPN) at risk of a poor outcome should be treated and what therapeutic regimen should be used [2, 5].
The traditional Chinese medicine (TCM) patterns of symptoms can reflect the nature of the interaction between the disease and the environment in a certain stage; they include the corresponding symptoms, signs, and tongue and pulse qualities and can reveal the etiology, disease character, disease location, and disease trend [7, 8]. Because of the flexibility and individualization of TCM syndrome differentiation, many doctors have different understandings for the syndrome differentiation and treatment of HSPN. Although the disease has a variety of patterns of TCM syndromes, the research showed that the common TCM syndrome of HSPN mainly includes four patterns: dampness-heat accumulation, liver-kidney yin deficiency, qi and yin deficiency, and purpura with syndrome of blood-heat bleeding [8, 9]. There are few reports on the relationship between TCM syndrome and renal function, immunologic function index, and blood coagulation index. This study aims to investigate the correlation between the patterns of TCM syndromes and...