生血灵联合小剂量糖皮质激素治疗激素抵抗型免疫性血小板减少症53例
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摘要
目的:观察生血灵联合小剂量糖皮质激素治疗激素抵抗型免疫性血小板减少症(ITP)的临床疗效。方法:将106例患者按随机数字表法分为观察组、对照组各53例。2组均给予小剂量激素治疗,观察组同时给予生血灵系列方辨证论治,对照组同时给予环孢素治疗,2组均连续治疗3个月,观察临床疗效及治疗前后患者生存质量的变化情况。结果:总有效率观察组为54.7%,对照组为37.7%,2组比较差异有统计学意义(P<0.05)。观察组治疗前后生理、心理、社会、环境等维度评分及总评分比较,差异有统计学意义(P<0.05)。对照组治疗前后心理评分及总评分比较,差异有统计学意义(P<0.05);生理、社会、环境等维度评分比较,差异无统计学意义(P>0.05)。生理、心理、社会、环境等维度评分及总评分治疗后2组组间比较,差异均有统计学意义(P<0.05)。结论:生血灵系列方联合小剂量糖皮质激素辨证治疗激素抵抗型ITP疗效显著,且有助于改善患者生存质量。
Objective: To observe clinical effects of Sheng Xue Ling combined with low-dose glucocorticoid in treating steroid-resistant idiopathic thrombocytopenic purpura(ITP). Methods: All 106 patients were allocated to the observation group and the control group according to random number table method, 53 cases each group, they were given low-dose glucocorticoid, the observation group were differentiated and treated with Sheng Xue Ling, the control group with ciclosporin simultaneously, they were treated for three months consecutively, clinical effects and the changes of survival quality of both groups were observed before and after treating. Results: Total effective rate of the observation group was 54.7%, and the control group was 37.7%, and the difference had statistical meaning(P<0.05).The difference was statistically significant in the comparisons of dimensional scales including physiology,psychology, society and environment, and total scales before and after treating within the observation group(P<0.05).The difference was statistically significant in the comparisons of psychological scales and total scales before and after treating within the control group(P <0.05); the difference had no statistical meaning in the comparisons of dimensional scales including physiology, society and environment(P>0.05), and there was a significant difference in the comparisons of dimensional scales including physiology, psychology, society and environment, and total scales between both groups(P <0.05). Conclusion: Sheng Xue Ling prescription series combined with low-dose glucoco-rticoid is effective in treating steroid-resistant ITP, and it is helpful to improve survival quality of the patients.
Objective: To observe clinical effects of Sheng Xue Ling combined with low-dose glucocorticoid in treating steroid-resistant idiopathic thrombocytopenic purpura(ITP). Methods: All 106 patients were allocated to the observation group and the control group according to random number table method, 53 cases each group, they were given low-dose glucocorticoid, the observation group were differentiated and treated with Sheng Xue Ling, the control group with ciclosporin simultaneously, they were treated for three months consecutively, clinical effects and the changes of survival quality of both groups were observed before and after treating. Results: Total effective rate of the observation group was 54.7%, and the control group was 37.7%, and the difference had statistical meaning(P<0.05).The difference was statistically significant in the comparisons of dimensional scales including physiology,psychology, society and environment, and total scales before and after treating within the observation group(P<0.05).The difference was statistically significant in the comparisons of psychological scales and total scales before and after treating within the control group(P <0.05); the difference had no statistical meaning in the comparisons of dimensional scales including physiology, society and environment(P>0.05), and there was a significant difference in the comparisons of dimensional scales including physiology, psychology, society and environment, and total scales between both groups(P <0.05). Conclusion: Sheng Xue Ling prescription series combined with low-dose glucoco-rticoid is effective in treating steroid-resistant ITP, and it is helpful to improve survival quality of the patients.
引文
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[10]中华医学会血液学分会止血与血栓学组.成人原发免疫性血小板减少症诊断与治疗中国专家共识(2016年版)[J].中华血液学杂志,2016,37(2):89-93.
[11]Kikuchi K,Miyakawa Y,Ikeda S,et al.Cost-effectiveness of adding rituximab to splenectomy and romiplostim for treating steroid-resistant idiopathic thrombocytopenic purpura in adults[J].BMC Health Serv Res,2015,27(15):2-9.
[12]吴春农.低剂量环孢A联合糖皮质激素治疗难治性自身免疫性血小板减少症的疗效观察[J].四川医学,2013,34(11):1696-1697.
[13]鲍计章,周永明,赵心华,等.生血灵系列制剂联合西药治疗激素抵抗型原发免疫性血小板减少症30例临床观察[J].中医杂志,2017,58(6):502-505.
[2]Frederiksen H,Christiansen CF,Norgaard M.Risk and prognosis of adult primary immune thrombocytopenia[J].Expert Rev Hematol,2012,5(2):219-228.
[3]Mcmillan R,Bussel JB,George JN,et al.Self-reported health-related quality of life in adults with chronic immune thrombocytopenic purpura[J].American Journal of Hematology,2008,14(2):201-211.
[4]Rodeghiero F,Stasi R,Gernsheimer T,et al.Standardization of terminology,definitions and outcome criteria in immune thrombocytopenic purpura of adults and children:report from an international working group[J].Blood,2009,113(11):2386-2393.
[5]中华医学会血液学分会血栓与止血学组.成人原发免疫性血小板减少症诊断与治疗中国专家共识(2012年版)[J].中华血液学杂志,2012,33(11):975-977.
[6]邓家栋,杨崇礼,杨天楹.邓家栋临床血液学[M].上海:上海科学技术出版社,2001:1324.
[7]郑筱萸.中药新药临床研究指导原则[M].北京:中国医药科技出版社,2002:182-184.
[8]Efficace F,Mandelli F,Fazi P,et al.Health-related quality of life and burden of fatigue in patients with primary immune thrombocytopenia by phase of disease[J].American Journal of Hematology,2016,27(4):171-181.
[9]尚淑玲,尚静雅,宋金萍,等.成人原发性免疫性血小板减少症患者合并抑郁调查分析[J].重庆医学,2014,43(27):3636-3637.
[10]中华医学会血液学分会止血与血栓学组.成人原发免疫性血小板减少症诊断与治疗中国专家共识(2016年版)[J].中华血液学杂志,2016,37(2):89-93.
[11]Kikuchi K,Miyakawa Y,Ikeda S,et al.Cost-effectiveness of adding rituximab to splenectomy and romiplostim for treating steroid-resistant idiopathic thrombocytopenic purpura in adults[J].BMC Health Serv Res,2015,27(15):2-9.
[12]吴春农.低剂量环孢A联合糖皮质激素治疗难治性自身免疫性血小板减少症的疗效观察[J].四川医学,2013,34(11):1696-1697.
[13]鲍计章,周永明,赵心华,等.生血灵系列制剂联合西药治疗激素抵抗型原发免疫性血小板减少症30例临床观察[J].中医杂志,2017,58(6):502-505.