健脾生血汤治疗气不摄血型慢性特发性血小板减少性紫癜的临床研究
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摘要
目的观察健脾生血汤治疗气不摄血型慢性特发性血小板减少性紫癜(idiopathic thrombocytopenic purpura, ITP)的临床疗效。方法将符合标准的100例患者随机分为对照组和治疗组,每组50例,两组分别采用激素强的松治疗和健脾生血汤合激素强的松治疗,3个月为1疗程,连用2个疗程。比较治疗前后两组血小板计数、血小板治疗疗效、中医症状积分、中医证候疗效及副反应情况。结果血小板计数比较:两组治疗后血小板计数均有所上升(P<0.05),治疗组血小板计数上升幅度高于对照组(P<0.05);血小板治疗疗效比较:对照组总有效率为82.0%,治疗组为90.0%,两组比较差异有统计学意义(P<0.05);中医症状积分比较:两组治疗后中医症状积分均有所下降(P<0.05),治疗后对照组中医症状积分减少幅度小于治疗组(P<0.05);中医证候疗效比较:对照组总有效率为82.0%,治疗组为92.0%,两组比较差异有统计学意义(P<0.05);副反应比较:对照组副反应发生率为100.0%,治疗组为54.0%,两组比较差异有统计学意义(P<0.05)。结论健脾生血汤能改善气不摄血型慢性ITP患者的中医证候,有效增加血小板计数,改善或消除激素副作用,有推广应用价值。
Objective To investigate the clinical efficacy of Jianpi Shengxue Decoction in the treatment of chronic idiopathic thrombocytopenic purpura(ITP) with Qi failing to control blood. Methods A total of 100 patients with chronic ITP with Qi failing to control blood were equally and randomly divided into control group and treatment group. The control group was given the glucocorticoid prednisone, while the treatment group was given Jianpi Shengxue Decoction combined with prednisone. Both groups were given two courses of treatment(3 months for a course). The changes in platelet count, response in platelet, traditional Chinese medicine(TCM) symptom score, response in TCM syndrome, and side effects after treatment were compared between the two groups. Results Comparison of platelet count: after treatment, both groups showed a significant increase in platelet count(P<0.05), and the treatment group had a significantly greater increase in platelet count compared with the control group(P<0.05); comparison of response in platelet: there was a significant difference in overall response ratebetween the control group and the treatment group(82.0% vs 90.0%, P <0.05); comparison of TCM symptom score: after treatment, both groups showed a significant decrease in TCM symptom score(P <0.05), and the control group had a significantly less decrease in TCM symptom score compared with the treatment group(P<0.05); comparison of response in TCM syndrome: there was a significant difference in overall response rate between the control group and the treatment group(82.0%vs 92.0%, P<0.05); comparison of side effects: there was a significant difference in the incidence rate of side effects between the control group and the treatment group(100.0% vs 54.0%, P <0.05). Conclusion For patients with chronic ITP with Qi failing to control blood, Jianpi Shengxue Decoction can effectively increase platelet count and ameliorate or eliminate the side effects of hormone therapy, so it holds promise for clinical application.
Objective To investigate the clinical efficacy of Jianpi Shengxue Decoction in the treatment of chronic idiopathic thrombocytopenic purpura(ITP) with Qi failing to control blood. Methods A total of 100 patients with chronic ITP with Qi failing to control blood were equally and randomly divided into control group and treatment group. The control group was given the glucocorticoid prednisone, while the treatment group was given Jianpi Shengxue Decoction combined with prednisone. Both groups were given two courses of treatment(3 months for a course). The changes in platelet count, response in platelet, traditional Chinese medicine(TCM) symptom score, response in TCM syndrome, and side effects after treatment were compared between the two groups. Results Comparison of platelet count: after treatment, both groups showed a significant increase in platelet count(P<0.05), and the treatment group had a significantly greater increase in platelet count compared with the control group(P<0.05); comparison of response in platelet: there was a significant difference in overall response ratebetween the control group and the treatment group(82.0% vs 90.0%, P <0.05); comparison of TCM symptom score: after treatment, both groups showed a significant decrease in TCM symptom score(P <0.05), and the control group had a significantly less decrease in TCM symptom score compared with the treatment group(P<0.05); comparison of response in TCM syndrome: there was a significant difference in overall response rate between the control group and the treatment group(82.0%vs 92.0%, P<0.05); comparison of side effects: there was a significant difference in the incidence rate of side effects between the control group and the treatment group(100.0% vs 54.0%, P <0.05). Conclusion For patients with chronic ITP with Qi failing to control blood, Jianpi Shengxue Decoction can effectively increase platelet count and ameliorate or eliminate the side effects of hormone therapy, so it holds promise for clinical application.
引文
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[11]吴玉霞,黄志惠,袁忠,等.健脾益气摄血颗粒对脾气虚型慢性免疫性血小板减少症淋巴细胞亚群的影响[J].湖南中医药大学学报,2016,36(9):65-68.
[12]李天天,侯丽,张雅月,等.从脾论治免疫性血小板减少性紫癜的理论基础与临床实践[J].北京中医药,2015,34(4):304-306.
[13]何昊,孙艳平,郑蕾,等.健脾益气摄血方对ITP模型小鼠外周血象的影响[J].中医药学报,2015,43(6):22-24.
[14]刘青,贾伟,郝建,等.王洪京应用健脾益气温中类对药治疗脾胃病的临床经验[J].中国中医药现代远程教育,2018,16(4):65-66.
[15]黄小平,李菲,陈凌波,等.黄芪和当归配伍对环磷酰胺所致骨髓造血功能抑制小鼠造血功能的影响[J].中草药,2017,48(1):121-128.
[16]王涵,杨娜,谭静,等.白术化学成分、药理作用及临床应用的研究进展[J].甘肃医药,2018,37(1):23-26.
[2]钟新林,谢军,武晓兰,等.健脾生血汤治疗慢性特发性血小板减少性紫癜40例总结[J].湖南中医杂志,2010,26(3):29-30.
[3]张之南,沈悌.血液病诊断及疗效标准[M].3版.北京:科学出版社,2007:173-174.
[4]吴勉华,王新月.中医内科学[M].3版.北京:中国中医药出版社,2012:370.
[5]吴顺杰,梁冰,李达.梁冰老中医治疗慢性特发性血小板减少性紫癜经验[J].深圳中西医结合杂志,2008,18(1):20-21,24.
[6] PODDIGHE D. Head trauma and intracranial hemorrhage in chil dren with idiopathic thrombocytopenic purpura[J]. Pediatric Emergency Care, 2015, 31(6):454.
[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,2002:180-184.
[8]罗耀光,刘燕群,胡俊,等.重组炙甘草汤配合小剂量糖皮质激素治疗特发性血小板减少性紫癜的临床观察[J].中国中西医结合杂志,2001,21(7):501-503.
[9]赵云鹏.中医应用中医辨证治疗血小板减少性紫癜70例临床观察[J].中国卫生标准管理,2016,7(17):143.
[10]陈一清.血小板减少性紫癜辨证施治规律若干问题探要[J].中医药学刊,2005,23(8):1457-1459.
[11]吴玉霞,黄志惠,袁忠,等.健脾益气摄血颗粒对脾气虚型慢性免疫性血小板减少症淋巴细胞亚群的影响[J].湖南中医药大学学报,2016,36(9):65-68.
[12]李天天,侯丽,张雅月,等.从脾论治免疫性血小板减少性紫癜的理论基础与临床实践[J].北京中医药,2015,34(4):304-306.
[13]何昊,孙艳平,郑蕾,等.健脾益气摄血方对ITP模型小鼠外周血象的影响[J].中医药学报,2015,43(6):22-24.
[14]刘青,贾伟,郝建,等.王洪京应用健脾益气温中类对药治疗脾胃病的临床经验[J].中国中医药现代远程教育,2018,16(4):65-66.
[15]黄小平,李菲,陈凌波,等.黄芪和当归配伍对环磷酰胺所致骨髓造血功能抑制小鼠造血功能的影响[J].中草药,2017,48(1):121-128.
[16]王涵,杨娜,谭静,等.白术化学成分、药理作用及临床应用的研究进展[J].甘肃医药,2018,37(1):23-26.