维血宁颗粒联合泼尼松治疗原发免疫性血小板减少症的临床疗效观察  

A clinical analysis of Weixuening granule combined with prednisone for treatment of patients with primary immune thrombocytopenia

作　　者：沈继春[1] 陈艳鑫[1] 岑冰[1] 葛海燕[1] 郭赟[1] 刘宝山[2] 

机构地区：[1]武警后勤学院附属医院血液科,天津300162 [2]天津医科大学总医院中医科,天津300052

出　　处：《中国中西医结合急救杂志》2015年第2期147-150,共4页Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care

基　　金：国家自然科学基金资助项目（81373847）

摘　　要：目的：观察维血宁颗粒联合泼尼松治疗原发免疫性血小板减少症（ITP）的疗效及对血小板相关免疫球蛋白（PAIgG、PAIgM、PAIgA）的影响。方法将60例ITP患者按随机数字表法分为观察组（30例，给予维血宁颗粒联合泼尼松治疗）和对照组（30例，单用泼尼松治疗）。3个月为1个疗程，观察治疗2个疗程后两组的临床疗效、血小板计数（PLT）、PAIgG、PAIgM、PAIgA、停用激素时间、1年复发率及不良反应发生率。结果观察组总有效率明显高于对照组的〔90.00%（27/30）比73.33%（22/30），P＜0.05〕；观察组停用激素时间较对照组明显缩短（d：39.8±7.8比55.3±6.5，P＜0.05），1年复发率较对照组明显降低〔23.3%（7/30）比50.0%（15/30），P＜0.05〕；两组治疗后PLT较治疗前明显增加，PAIgM、PAIgA均较治疗前降低，且观察组的改善程度优于对照组〔PLT（×10^9/L）：113.25±15.47比84.79±20.37，PAIgM：（28.91±10.42）%比（30.75±9.37）%， PAIgA：（19.32±11.54）%比（21.15±15.16）%〕；观察组治疗后PAIgG水平明显降低，对照组治疗前后PAIgG水平差异无统计学意义，观察组治疗后PAIgG明显低于对照组〔（15.29±9.02）%比（32.41±9.34）%，P＜0.05〕。两组不良反应均以向心性肥胖、多毛症、痤疮、高血糖等为主，观察组不良反应发生率低于对照组，但差异无统计学意义〔73.3%（22/30）比86.7%（26/30），P＞0.05〕。结论维血宁颗粒联合泼尼松治疗ITP的临床疗效优于单用泼尼松，且不良反应少，可能与联合用药可降低血小板相关免疫球蛋白、增加血小板生成有关。Objective To observe the clinical efficacy of Weixuening granule combined with prednisone for treatment of patients with primary immune thrombocytopenia （ITP） and its impact on platelet-associated antibodies（PAIgG, PAIgM, PAIgA）. Methods Sixty patients with ITP were randomly divided into a observation group （30 cases, Weixuening granule combined with prednisone） and a control group （30 cases, prednisone therapy alone）, 3 months constituting a therapeutic course. The clinical effects, platelet count （PLT） and PAIgG, PAIgM, PAIgA of two groups were observed after two courses of treatment. The time of withdrawing prednisone, relapse rate in 1 year and adverse reactions were also monitored. Results The total effective rate of the observation group was higher than that of the control group [90.00%（27/30） vs. 73.33%（22/30）, P〈0.05]. The time of withdrawing prednisone was significantly shorter in the observation group than that in the control group（days：39.8±7.8 vs. 55.3±6.5, P〈0.05）. The relapse rate in 1 year in the observation group was obviously lower than that of the control group [23.3%（7/30） vs. 50.0%（15/30）, P 〈 0.05]. The PLT levels were markedly increased after treatment in the two groups, the levels of platelet-associated antibodies PAIgM and PAIgA after treatment in the two groups were lower than those before treatment, and the degree of improvement in observation group was superior to that of the control group [PLT （×10^9/L）：113.25±15.47 vs. 84.79±20.37, PAIgM：（28.91±10.42）%vs. （30.75±9.37）%, PAIgA：（19.32±11.54）%vs. （21.15±15.16）%]. The level of PAIgG in the observation group was decreased obviously after treatment, while in the control group, it did not have significant change before and after treatment, and in the comparison of the level of PAIgG after treatment between the two groups, there was statistical significant difference [（15.29±9.02）%vs （32.41±9.34）%, P〈0.05]. There were adverse reactions in the two gr

关 键 词：维血宁颗粒 泼尼松 原发免疫性血小板减少症 临床疗效观察 

分 类 号：R558.2[医药卫生—血液循环系统疾病]