重组人血小板生成素联合中药辨证治疗老年难治性原发免疫性血小板减少症临床研究  

Clinic research on old refractory idiopathic throm-bocytopenic purpura(rITP) by means of recombinant human thrombopoietin(rhTPO) combined with Chinese traditional medicine

作　　者：吴玉霞[1] 袁忠[2] 马西虎[1] 黄志惠[1] 费飞[1] 

机构地区：[1]新疆医科大学附属中医医院血液科,乌鲁木齐830011 [2]新疆医科大学附属中医医院肾病科,乌鲁木齐830011

出　　处：《新疆医科大学学报》2015年第7期884-887,共4页Journal of Xinjiang Medical University

基　　金：新疆维吾尔自治区自然科学基金(201233146-18)

摘　　要：目的探讨重组人血小板生成素联合中药辨证治疗老年难治性原发免疫性血小板减少症的临床疗效。方法选择老年难治性原发免疫性血小板减少症患者43例,随机分为治疗组和对照组,对照组患者给予标准剂量重组人血小板生成素(rhTPO,300IU/kg,剂型15 000IU/支)治疗,治疗组(20例)又分为3型,在标准剂量rhTPO应用基础上,加中药辩证治疗,随访时间为2个月,比较两组及治疗组3型治疗后血小板水平、疗效、出血部位和维持缓解情况等相关指标的变化。结果 (1)两组患者治疗14d后血小板(PLT)>20×109个/L者比例分别为85.00%(17/20)及73.91%(17/23),差异无统计学意义(P>0.05);(2)治疗组总有效率为60.00%,对照组总有效率为30.43%,差异有统计学意义(P<0.05);治疗组中气不摄血型有效率优于其他证型,差异有统计学意义(P<0.05);(3)治疗组治疗有效患者中12例后续维持PLT>20×109个/L,对照组治疗有效患者中7例后续维持PLT>20×109个/L,差异有统计学意义(P<0.05),治疗组3型疗效比较差异有统计学意义。(4)治疗组与对照组出血情况(部位)比较差异有统计学意义(P<0.05);治疗组不同证型出血情况(部位)比较差异有统计学意义(P<0.05)。结论 rhTPO联合中药辨证治疗老年难治性原发免疫性血小板减少症的疗效优于单纯采用rhTPO治疗。Objective To observe the therapeutic effect on old refractory idiopathic throm-bocytopenic pur-pura by means of recombinant human thrombopoietin （rhTPO）combined with traditional Chinese medi-cine.Methods 43 cases of old patients with rITP were randomly divided into two groups：20 patients in treatment group,with orally rhTPO combined with Chinese traditional medicine;23 patients in the control group,with rhTPO.The therapeutic course lasted for 2 months.The platelet count level,the bleeding site and the maintenance of remission were observed before and after treatment and clinical effica-cy of the treatment was compared and evaluated.Results （1）The effect rate of PLT〉20x10 9 for 14daystreatment was 85% in the treatment group and 73.91% in the control group respectively,without signifi-cant diffidence in two groups （P 〉0.05）;（2）The total effective rate was 60% in the treatment group and 30.43% in the control group respectively,with significant diffidence in two groups （P〈0.05）;The total effective rate showed significant diffidence in three different TCM types in the treatment group （P〈0.05）,with superior effect in the type of Qi failing to control blood to the others types;（3）The improve-ment of the hemorrhage and maintained remission in the treated group were superior to those in the control group （P〈0.05）,with significant diffidence in three different TCM types in the treatment group （P〈0.05）,with superior effect in type of Qi failing to control blood to the others;（4）It proved that the effica-cy had a positive correlation with the number of megakaryocyte.Conclusion It proved that the therapy of rhTPO combined with Chinese traditional medicine had a superior clinic efficacy to rhTPO therapy on old refractory idiopathic throm-bocytopenic purpura,with the improvement in the level of peripheral blood platelet in a short time,effective control of bleeding symptoms and prolonged maintain remission.

关 键 词：老年难治性原发免疫性血小板减少症 重组人血小板生成素 中药 

分 类 号：R24[医药卫生—中医临床基础]