Patients with this disease often have bleeding spots on their skin, so they are psychologically nervous. They should comfort patients and introduce rehabilitation cases, so that they can build up confidence in overcoming diseases. They should pay attention to life adjustment, stay in bed at acute stage and do less exercise. Because exercise can accelerate blood circulation and aggravate bleeding, we should often take part in physical exercise during the remission period, enhance physical fitness, prevent colds, actively remove infection focus, prevent upper respiratory tract infection, avoid all allergens and prevent the inducing factors of this disease. Diet regulation is also very important. Henoch-Schonlein purpura, also known as purpura, is an allergic vasculitis that invades capillaries and arterioles of skin or other organs. It mostly occurs in male children and is characterized by thrombocytopenic purpura, often accompanied by abdominal pain and joint symptoms.
clinical picture
1, symptoms and signs 1) Symptoms of prodromal symptoms often include mild sore throat, upper respiratory tract infection and general malaise 3 weeks before onset 1 ~ 3 weeks.
2) Typical symptoms and signs have different clinical manifestations depending on the lesion site (1) Skin symptoms: papular purpura of different sizes is distributed symmetrically in batches near the main joints of the lower limbs and buttocks, and occurs repeatedly in the buttocks of the limbs. A few skin lesions involving the face and trunk initially have itchy skin, including urticaria, angioneurotic edema and erythema multiforme. (2) Joint symptoms: there may be swelling or arthritis of one or more wandering joints. Clinically, it is called joint type (3) gastrointestinal symptoms: about 2/3 patients may have paroxysmal abdominal cramps or persistent dull pain, and may be accompanied by vomiting, hematemesis or bloody stool. Clinically it is called abdominal type. (4) Renal symptoms: Generally, gross hematuria, microscopic hematuria, proteinuria, and tubulointeruria occur about 2-4 weeks after purpura, and may also occur after the rash subsides or the disease stops. Usually, severe cases can be recovered within a few weeks, leading to renal dysfunction, azotemia's disease and hypertensive encephalopathy. A few cases of hematuria, proteinuria or hypertension can last for more than 2 years. Clinically called renal type. 2. Common complications include intussusception intestinal obstruction, intestinal perforation, hemorrhagic necrotizing enteritis, intracranial hemorrhage, polyneuritis myocarditis, acute pancreatitis, orchitis and pulmonary hemorrhage.
Nephritis symptom
The symptoms of nephritis usually occur within 1 month, and some may be as late as 3 ~ 6 months or even more than 2 years. The main clinical manifestations are as follows: 1. Hematuria is gross hematuria or microscopic hematuria, which can persist or appear intermittently and get worse after infection or purpura attack. Most cases are accompanied by different degrees of proteinuria. 2. The degree of proteinuria varies, which is not necessarily proportional to the severity of hematuria. Proteinuria is mostly moderate, and the decrease of plasma protein level is more obvious than the severity of proteinuria. It may be that protein leaked from the gastrointestinal tract, subcutaneous tissue and other parts except the kidney. Some cases may manifest as nephrotic syndrome or acute nephritis syndrome. The edema and hypertension of the latter are relatively inconspicuous. 3. Hypertension is generally mild, and obvious hypertension is mostly poor prognosis. 4. A few other patients have edema, most of which are mild. Acute edema often leads to elevated blood pressure, suggesting a wide range of lesions. The causes of edema are related to proteinuria, gastrointestinal protein loss and capillary permeability changes. In addition, patients are often accompanied by joint pain, skin purpura, abdominal pain, general discomfort and other manifestations. Renal function is generally normal, and a few patients have a transient increase in serum creatinine and urea nitrogen. Serum IgA and IgM are mostly increased, and IgG is normal. C3 and CH50 are mostly normal, and cryoglobulin is elevated in many cases.
complication
1, gastrointestinal bleeding: related to intestinal mucosal injury. 2. Purpura nephritis: It is related to allergic inflammation of renal capillaries. It is more important to eliminate the inducement in the treatment of allergic purpura. We should try to avoid long-term or short-term high-dose injection or oral corticosteroids such as dexamethasone, Kangning Ke Tong and prednisone, because corticosteroids can quickly improve or disappear the above conditions. However, it is easy to aggravate the rebound after stopping the drug. Long-term use of large doses of glucocorticoid can also cause obesity, hirsutism, acne, elevated blood sugar, hypertension, sodium retention, edema, hypokalemia, menstrual disorder, osteoporosis, aseptic osteonecrosis, gastric and duodenal ulcers and other complications. It can also cause certain damage to the kidney, such as aggravating glomerular disease proteinuria, aggravating glomerulosclerosis, easily causing renal calcification or calculus, inducing or aggravating renal infectious diseases, and causing hypokalemic nephropathy. It can also cause metabolic disorder of a series of substances such as sugar, protein, fat, water and electrolyte, destroy the body's defense system and inhibit immune response. Therefore, if the illness is urgent, it must be used reasonably under the correct guidance of a specialist. If the patient relies on corticosteroids during treatment, it should be gradually reduced until the drug is completely stopped. After stopping glucocorticoid, the primary disease will be aggravated, and the secondary side effects will bring great pain to patients. Doctors and patients' families should do a good job in patients' ideological work, fully understand the side effects after stopping corticosteroids, and enhance their confidence in overcoming the disease. The methods and traditional Chinese medicines to combat the above-mentioned side effects and adverse reactions should be selected when the therapeutic drugs are correctly selected and corticosteroids are gradually reduced until they are stopped. Achieve the goal of safely and thoroughly curing diseases. Patients must also keep in mind allergens and avoid eating or touching allergens, otherwise it will aggravate the condition.
Edit the symptom type of this paragraph.
Most patients with Henoch-Schonlein Purpura have prodromal symptoms such as general malaise, low fever, fatigue and upper respiratory tract infection before onset 1-2 weeks, followed by typical clinical manifestations. According to the different symptoms and signs, it can be divided into the following types:
1, simplex
Is that most common type. The main manifestation is cutaneous purpura. Purpura varies in size and can be fused into a block to form ecchymosis. Purpura is mainly confined to the limbs, especially the lower limbs and buttocks, and rarely occurs in the trunk. It can be accompanied by skin edema and urticaria at the same time, and gradually subside after 7- 14 days.
2. Abdominal style
In addition to cutaneous purpura, there are a series of gastrointestinal symptoms and signs (about 2/3 patients) caused by the involvement of gastrointestinal mucosa and peritoneal visceral capillaries, such as nausea, vomiting, hematemesis, diarrhea, mucus stool, bloody stool and so on. Among them, abdominal pain is the most common, often paroxysmal colic, mostly located around the umbilicus, lower abdomen or the whole abdomen. During the attack, due to abdominal muscle tension, obvious tenderness and hyperactivity of bowel sounds, it can be misdiagnosed as surgical acute abdomen. In young children, intussusception can be caused by edema and increased peristalsis of the intestinal wall. Abdominal symptoms and signs often appear at the same time as cutaneous purpura, and occasionally appear before purpura.
3, joint type
In addition to cutaneous purpura, joint swelling, pain, tenderness and dysfunction (about 1/2 patients have joint symptoms) occur due to vascular involvement in joint parts, mostly in knees, ankles, wrists and elbows. Joint swelling is generally mild, wandering and recurrent, and there is no residual joint deformity.
4. Kidney type
The disease is the most serious, with the incidence rate as high as 12%-40%. In addition to cutaneous purpura, hematuria, proteinuria and tubular urine are caused by the inflammatory reaction of glomerular capillaries. Renal symptoms can appear at any stage of the disease, but they are more common one week after purpura. It is generally believed that the earlier urine changes appear, the more serious nephritis will be. A few cases will develop into chronic nephritis (hematuria, proteinuria, edema, hypertension) and nephrotic syndrome (proteinuria >: 3.5g/d, hypoproteinemia.
5. Mixed type
Except cutaneous purpura, two or more of the other three types coexist.
6. Others
In addition to the above-mentioned common types, a few patients can also have optic atrophy, iritis, retinal hemorrhage and edema, as well as symptoms and signs related to the central nervous system, because the blood vessels of the eyes, brain and meninges are involved.
Edit this TCM classification
This disease is called "purpura" and "purple spot" in traditional Chinese medicine, which belongs to the category of blood syndrome in traditional Chinese medicine. Symptoms such as "grape plague", "necrophilia" and "spot poison" recorded in ancient medicine in China are similar to this disease.
1, wind and heat damage the body
The onset of the syndrome is more acute, and the skin purpura is scattered all over the body, especially in the lower limbs and buttocks, with symmetrical distribution, bright red color and different sizes, or accompanied by itching, fever, abdominal pain, joint swelling and pain, hematuria and so on. Red tongue, thin yellow fur and floating pulse. Syndrome differentiation is caused by exogenous wind-heat and internal circulation of blood vessels. The key points of syndrome differentiation are acute onset, scarlet purpura and exterior syndrome of wind-heat
2. Blood-heat rash
Syndrome onset is acute, with petechiae and ecchymosis on the skin, bright red, or accompanied by epistaxis, epistaxis, bloody stool and urine, bright red or purplish red, accompanied by upset, thirst, constipation, abdominal pain, or fever, red tongue and strong pulse. According to the syndrome differentiation, this syndrome is caused by excessive heat toxin, forced blood rushing to ren, burning collaterals and extravasation of blood. The key points of syndrome differentiation are acute onset, purpura and other bleeding bright red, heat toxin overflowing, and blood stagnation.
3, qi does not take blood
Syndrome onset is slow, the course of disease is prolonged, purpura, ecchymosis and purple ecchymosis appear repeatedly, and nosebleed, gnashing teeth, pale face, fatigue, loss of appetite, dizziness, palpitation, pale tongue with thin fur and weak pulse often appear. Syndrome differentiation is caused by chronic illness and qi deficiency can't suck blood. The key points of syndrome differentiation are prolonged course of disease, mild purpura, repeated appearance and deficiency of qi and blood.
4. Yin deficiency and excessive fire
Syndrome: Purpura occurs from time to time, with nosebleed, gnashing teeth, scarlet blood, low fever, night sweats, vexation, insomnia, dry stool, Huang Chi in urine, red tongue, little fur and rapid pulse. Syndrome differentiation is yin deficiency and excessive fire, which burns blood collaterals. The key points of syndrome differentiation are purple spots and bright red blood, accompanied by yin deficiency and excessive fire.
You won't let me publish it here.
/view/ 18069.htm？ Fr=ala0_ 1_ 1 My father had this disease before, and he recovered a few years later.
It can still be treated.