Abstract: Objective To investigate the effect of the ladder treatment with traditional Chinese and western medicine in the prevention of early renal injury of Henoch-Schonlein purpura(HSP).
Methods A total of 1 010 children with HSP from January 2014 to January 2015 were collected, and were divided into program 1(731 cases) and program 2(279 cases). Different programs were adopted for the ladder treatment. By cohort study, renal injury rates were compared in treatment, abdominal pain, and clinical typing.
Results (1)The rate of renal damage after treatment was 13.82%(101/731) and 18.64%(52/279) for program 1 and program 2,respectively, and there was no statistical difference between the two programs(P>0.05).The rate of mild+moderate renal damage was 90.1%(91/101) for program 1, which was higher than that for program 2（76.9%,40/52）(P<0.05); the degree of renal damage for program 1 was lower. The duration of renal involvement in program 1 was （52.48±31.44）d, and it was （40.39±27.18）d in program 2, the difference being statistically significant(P<0.05).(2)In the 1 010 HSP children, 462 had abdominal pain,87(18.83%) had renal damage within 3 months, and the rate of renal damage in the children with ,moderate and severe abdominal pain was higher than in those with mild pain, and there was statistical difference(P<0.05). The rate of renal damage was 19.61% (41/209) in the abdominal type and 18.18% (46/253) in the mixed type, which was higher than that in the skin type(11.16%,24/215）,the difference being statistical(P<0.05).
Conclusion (1)Both of the two kinds of programs can reduce the rate of renal damage in HSP, and the combination ladder treatment of traditional Chinese medicine with western medicine is effective in the prevention of renal damage. (2)Renal damage is more likely to occur in children with abdominal-type and mixed-type HSP, and the more severe the abdominal pain, the higher the rate of renal damage.

Key words: Henoch-Schonlein purpura, Renal damage, Cohort study, Children