怡癜饮治疗激素依赖性原发免疫性血小板减少症30例临床观察  

Clinical Observation on Yidianyin( 怡癜饮) Treating 30 Cases of Steroid-Dependent Idiopathic Thrombocytopenic Purpura( ITP)

作　　者：李达[1] 胡永珍[1] 陈瑶[1] 韩凌[1] 危建安[1] 王青青[2] 陈丹涛 代喜平[1] 曹远芳 武彦琴 

机构地区：[1]广东省中医院,广东省广州市大德路111号510120 [2]广州中医药大学

出　　处：《中医杂志》2015年第17期1479-1482,共4页Journal of Traditional Chinese Medicine

基　　金：广东省科技计划项目(2011B061300076)

摘　　要：目的观察怡癜饮治疗激素依赖性原发免疫性血小板减少症(ITP)患者临床疗效及可能作用机制。方法 60例激素依赖性ITP患者随机分为治疗组和对照组各30例,另设10例健康志愿者为健康组。两组在维持原激素剂量治疗基础上,治疗组予以怡癜饮口服治疗,每日1剂,对照组予以常规免疫抑制剂治疗,治疗期间两组患者开始减撤激素。两组治疗3个月时无效者退出研究,有效者继续治疗至6个月。比较两组患者治疗前后激素用量及减撤率、外周血淋巴细胞糖皮质激素受体(GR)阳性率(包括GRα和GRβ两种亚型),并判定临床疗效。结果两组治疗后3、6个月临床疗效比较,治疗组均优于对照组(P<0.05)。治疗组激素减撤成功率为76.67%,对照组为26.67%,治疗组明显高于对照组(P<0.05)。治疗组治疗后3、6个月与本组治疗前比较激素用量明显降低(P<0.05)。治疗前两组患者外周血淋巴细胞GRα较健康组下降,GRβ明显上升(P<0.05)。治疗后3个月两组患者GRα表达均较本组治疗前有所上升(P<0.05),且治疗组高于对照组(P<0.05)。结论怡癜饮能降低激素依赖性ITP患者激素用量,促进激素的成功减撤,其机制可能与升高外周血淋巴细胞GRα表达有关。Objective To observe therapeutic effects of Yidianyin treating patients suffering from steroid-dependent idiopathic thrombocytopenic purpura（ ITP） and its possible mechanism. Methods Divided 60 cases of steroiddependent ITP patients randomly into treatment group and control group,with 30 cases each. Set another 10 cases of healthy volunteers as healthy group. Treatment group was given Yidianyin orally,one dose daily,while control group was given normal immunosuppressor,all based on maintaining intrinsic glucocorticoid dosage and starting to withdraw glucocorticoid. Patients with no curative effects at the third month were excluded. Patients having got curative effects continued the treatment until the sixth month. Compared glucocorticoid dosage and withdrawal rate,positive rate of peripheral blood lymphocyte glucocorticoid receptor（ GR）（ including subtypes GRαand GRβ） of patients in both groups before and after treatment,and determined its clinical curative effects. Results Effects of treatment group were all superior to that of control group at the third and the sixth month after treatment（ P〈0. 05）. The success rate of glucocorticoid withdrawal of treatment group was 76. 67%,with that of control group was 26. 67%,in which treatment group was remarkably superior to control group（ P〈0. 05）. Glucocorticoid dosage of treatment group three and six months after treatment remarkably decreased compared with that before treatment（ P〈0. 05）. Peripheral blood lymphocyte GRα of patients in two groups before treatment all decreased compared with that of healthy group,with GRβ remarkably increased（ P〈0. 05）. Three months after treatment GRα expression of patients in two groups increased compared with that before treatment（ P〈0. 05）,with that of treatment group higher than that of control group（ P〈0. 05）. Conclusion Yidianyin could decreased glucocorticoid dosage of steroid-dependent ITP patients,promote success of glucocorticoid withdrawal. Its mechanism may be related wit

关 键 词：原发免疫性血小板减少症 怡癜饮 调肝扶脾法 激素依赖 糖皮质激素受体 

分 类 号：R259[医药卫生—中西医结合]