生血灵治疗特发性血小板减少性紫癜临床研究  

Clinical study on idiopathic thrombocytopenic purpura treated with "Shengxueling Granule"

作　　者：鲍计章[1] 赵心华[2] 周永明[1] 朱文伟[1] 陆嘉惠[1] 胡明辉[1] 何玮[1] 薛志忠[1] 

机构地区：[1]上海中医药大学附属岳阳中西医结合医院血液科,上海200437 [2]上海中医药大学基础医学院,上海201203

出　　处：《上海中医药杂志》2011年第12期46-48,55,共4页Shanghai Journal of Traditional Chinese Medicine

基　　金：上海市卫生局中医药科研基金资助项目(2008Q002L);上海市高校选拔培养优秀青年教师科研专项基金资助项目(szy08089);上海市科委科研基金资助项目(10DZ1974100)

摘　　要：目的观察生血灵治疗特发性血小板减少性紫癜(ITP)的临床疗效,并探讨其作用机制。方法将60例患者随机分为治疗组和对照组(各30例),治疗组辨证予生血灵治疗,对照组用糖皮质激素(强的松)治疗;两组疗程均为3个月,观察临床疗效及血小板计数、血小板相关抗体(PAIg)、相关细胞因子(interleukin-4、interleukin-6、TNF-α)等指标的变化情况。结果治疗组、对照组总有效率分别为93.33%、66.67%;组间临床疗效比较,差异有统计学意义(P<0.05)。治疗组、对照组治疗前与正常组比较,血清IL-4、IL-6、TNF-α、PLT、PAIgG、PAIgA、PAIgM差异均有统计学意义(P<0.05)。治疗组ITP高表达的细胞因子IL-6、IL-4、TNF-α水平治疗后显著下降(P<0.05),对照组上述各指标治疗后均无明显变化(P>0.05);治疗组、对照组治疗后组间比较,上述各指标差异均有统计学意义(P<0.05)。治疗组、对照组治疗前后组内比较,PLT、PAIgG、PAIgA、PAIgM差异有统计学意义(P<0.05);组间治疗后比较,各指标差异均有统计学意义(P<0.05)。结论生血灵治疗ITP疗效良好,可调节患者细胞因子释放,减少血小板抗体的形成,减少血小板破坏。Objective To observe the clinical efficacy of ＂Shengxueling Granule＂ （SXL） in treating idiopathic thrombocytopenic purpura（ITP） and stmly its mechanisms. Methods Sixty patients with ITP were divided into two groups randomly. Thirty patients in treatment group were treated with SXL, and thirty patients in treatment group were treated with prednisone, with the course of 3 months. The therapeutic effect, blood platelet count, levels of platelet-assoeiated antibody （PAIg） and the cytokines（IL-4, IL-6, TNF-a） were observed. Results The total effective rates were 93.33% and 66.7% in treatment and control group respectively ; there was a significant difference in therapeutic effect between the two groups （ P 〈 0.05 ） ; the differences of IL-4, IL-6, TNF-a , PLT, PAIgG, PAIgA and PAIgM between trealment and control groups before treatment and normal group were significant （P 〈 0.05 ）. The levels of IL-6, IL-4 and TNF-a were decreased significantly after treatment in treatment group（ P 〈 0.05 ）, but without obvious difference between before and after treatment in control group（ P 〉 0.05 ） ; these indexes in control group and treatment group after treatment had significant differences （P 〈 0.05 ）. Between before and after treatment, the levels of PLT, PAIgG, PAIgA and PAIgM had significant differences in both treatment and control groups （ P 〈 0.05 ）, and Significant differences were found between the two groups after treatment（ P 〈 0.05 ）. Conclusion ＂Shengxueling Granule＂ is quite effective for ITP by releasing cytokine, suppressing the formation of platelet antibody and reducing the platelet destruction.

关 键 词：特发性血小板减少性紫癜 中医药疗法 生血灵 细胞因子 白细胞介素 血小板抗体 

分 类 号：R554.6[医药卫生—血液循环系统疾病]