摘要
目的:观察疏肝化瘀汤治疗气滞血瘀型原发性血小板增多症(essential thrombocythemia,ET)患者的临床疗效及安全性。方法:60例气滞血瘀型ET患者随机分为对照组和观察组,每组各30例。对照组采用羟基脲治疗,观察组在对照组治疗基础上给予疏肝化瘀汤。治疗后,比较两组患者临床疗效、中医证候积分、血液流变学指标、血常规、缓解和起效时间、脾大回缩情况及不良反应比较。结果:观察组有效率为93. 33%,对照组为73. 33%,两组比较,差异有统计学意义(P <0. 05)。与治疗前比较,治疗后两组中医证候积分均明显下降(P <0. 01);观察组治疗后中医证候积分显著低于对照组治疗后(P <0. 01)。观察组治疗后血液流变学指标均明显改善(P <0. 01)。两组治疗后血小板计数均明显下降(P <0. 01);观察组治疗后显著低于对照组,差异有统计学意义(P <0. 01)。观察组缓解持续时间长于对照组,起效时间显著低于对照组,差异均有统计学意义(P <0. 05)。治疗后,观察组脾大回缩率(回缩≥1/2)为80%,对照组为40%,两组比较,差异有统计学意义(P <0. 05)。两组患者不良反应比较,差异无统计学意义(P> 0. 05)。结论:疏肝化瘀汤治疗气滞血瘀型ET疗效显著,可有效减少血小板聚集,改善血液高凝状态,且起效时间快,缓解持续时间长,促进临床症状的缓解,回缩增大脾脏,安全性较好。
Objective: To observe the clinical efficacy and safety of Shugan Huayu Decoction in the treatment of qi stagnation and blood stasis type of essential thrombocythemia( ET). Methods: Sixty patients with qi stagnation and blood stasis type of ET were randomly divided into control group and observation group,30 cases in each group. The control group was treated with hydroxyurea,and the observation group was given Shugan Huayu Decoction on the basis of the treatment of the control group. After treatment,the clinical efficacy,TCM syndrome scores,hemorheology indicators,blood routine,remission and onset time,splenomegaly retraction and adverse reactions were compared between the two groups. Results: The effective rate was 93. 33% in the observation group and 73. 33% in the control group. The difference was statistically significant( P < 0. 05). Compared with before treatment,the scores of TCM syndromes in both groups decreased significantly after treatment( P < 0. 01). The scores of TCM syndromes in the observation group were significantly lower than those in the control group( P < 0. 01). The blood rheology indexes of the observation group were significantly improved after treatment( P < 0. 01). The platelet counts of the two groups were significantly decreased after treatment( P < 0. 01). The observation group was significantly lower than the control group after treatment( P < 0. 01). The remission and onset time of the observation group was significantly lower than that of the control group,and the difference was statistically significant( P < 0. 05). After treatment,the splenomegaly retraction rate( retraction≥1/2) was 80% in the two groups,and 40% in the control group. The difference was statistically significant( P < 0. 05). There were no significant differences in adverse reactions between the two groups( P > 0. 05). Conclusion: Shugan Huayu Decoction has significant curative effect on qi stagnation and blood stasis type of ET,which can effectively reduce platelet aggregation,improve blood hypercoagulability state,fast onset time,relieve long duration,promote the relief of clinical symptoms,retract and enlarge spleen,and have better security.
引文
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