清肝化瘀汤治疗真性红细胞增多症临床研究  

Clinical Research of Treatment of Polycythemia Vera with Qinggan Huayu Decocotion

作　　者：朱小勤[1] 邱仲川[1] 陈珮[1] 赵琳[1] 黄中迪[1] 胡晓莹[1] 

机构地区：[1]上海中医药大学附属曙光医院,上海200021

出　　处：《辽宁中医杂志》2013年第5期958-962,共5页Liaoning Journal of Traditional Chinese Medicine

摘　　要：目的:观察清肝化瘀汤治疗真性红细胞增多症的临床疗效,并与单用西药组的治疗对照。方法:观察血瘀证候改善情况,测评治疗前后外周血象、血液流变学、临床完全缓解率及疗效,以及JAK2V617F基因突变阳性患者的临床特征与实验室指标比较,分析对比两组治疗对JAK2基因突变阳性与阴性患者的差异。结果:清肝化瘀汤组临床完全缓解率73.33%,单用西药组为40%,清肝化瘀汤对于PV患者能够改善"血瘀"证候,相较于单用西药组,能明显改善皮下瘀斑、脉络瘀血、肌肤甲错的症状,并能够抑制外周血象,降低全血黏度、血浆黏度以及纤维蛋白原(P<0.05),但对贫血和肝脾肿大变化不明显,对骨髓增生程度改变不明显。结论:清肝化瘀汤能够明显改善血瘀证候和相关实验室指标,提高生活质量,减轻临床症状,减少并发症,抑制血小板聚集,疗效确切、安全持久。Objective ：To observe the clinical effect of Qinggan Huayu Decoction （QGHYD）in the treatment of polycythemia Vera （PV） , and control of treatment with western medicine group. Methods ： The blood stasis symptoms evaluation procedures, e- valuation before and after treatment of peripheral blood routines, blood theology, clinical complete remission rate, curative effect of two groups were compared. And for patients about mutation of JAK2V617F gene positive group, the clinical features and laborato- ry,analysis and comparison of two groups of treatment differences between positive and negative mutation in patients with JAK2V617F gene were compared. Results： QGHYD group complete clinical efficiency was 73.33%, for western medicine only group ; the total efficiency was 35.71%. For patients with PV, QGHYD can improve the blood stasis symptoms, compared to the group treated with western medicine alone, it can significantly improve the subdermal ecchymosis, blood stasis of arteries and veins, squamous and dry skin symptoms, and can inhibit the peripheral blood routines, decrease blood viscosity, plasma viscosity and fibrinogen（ P 〈 0. 05 ） ,anemia and hepatosplenomegaly did not change significantly, and there was no obvious change of bone marrow hyperplasia. Conclusion：QGHYD could alleviate the blood stasis symptoms and related laboratory parameters,improve the quality of life,reduce complications, reduce the clinical symptoms, inhibit platelet aggregation. Its curative effect on PV is con- firmed, safe and durable.

关 键 词：真性红细胞增多症 清肝化瘀汤 JAK2V617F基因突变 

分 类 号：R714.254[医药卫生—妇产科学]