中西医结合治疗难治性特发性血小板减少性紫癜临床疗效观察  

Clinical Curative Effect Observation of Combining Traditional Chinese and Western Medicine Treatment of Refractory Idiopathic Thrombocytopenic Purpura

作　　者：万芳[1] 杨俊艳[1] 王琳[1] 成玉洁 

机构地区：[1]甘肃省白银市第一人民医院,甘肃白银730900

出　　处：《中国医学创新》2016年第23期109-112,共4页Medical Innovation of China

摘　　要：目的：观察中西医结合治疗难治性血小板减少性紫癜（RITP）的临床疗效。方法：50例RITP患者随机分为治疗组25例和对照组25例。治疗组应用补脾养肝消癜汤，1剂/d，水煎服，联合小剂量强的松20～30 mg/d，激素逐渐减量；对照组用泼尼松1～2 mg/（kg·d），效果不佳者，加用免疫抑制剂（硫唑嘌呤、达那唑）；两组疗程均为90 d，观察疗效。结果：治疗组总有效率为84.00%，对照组为68.00%，两组比较差异有统计学意义（P〈0.05）。在出血症状的控制方面及出血停止后发生再次出血的时间方面，治疗组均优于照组（P〈0.05）。治疗后1、2、3个月，治疗组血小板计数改善情况均优于对照组（P〈0.05）。治疗组未发生明显不良反应，对照组伴发不同程度的高血压3例、高血糖2例、应激性溃疡1例，不良反应发生率24.00%。结论：补脾养肝消癜汤联合小剂量激素治疗难治性血小板减少性紫癜，疗效肯定，且治疗过程中无明显不良反应，值得临床进一步推广应用。Objective：To observe the clinical curative effect of combination of traditional Chinese and western medicine treatment of refractory idiopathic thrombocytopenic purpura （RITP）.Method：The 50 patients with RITP were randomly divided into treatment group（n=25） and control group（n=25）,the treatment group used Tonifying Spleen Nourishing Liver Xiaodian Soup,1 dose/d water decoction,in combination with small dose of Prednisone 20-30 mg/d,gradually reduced hormone.The control group treated with Prednisone 1-2 mg/（kg·d）, if the effect was poor,combined with immunosuppressant（Azathioprine,Danazol）.Two groups of treatment were based on 90 d,the curative effect was observed.Result：The total effective rate of the treatment group was 84.00%, the control group was 68.00%,the difference was statistically significant（P〈0.05）.The the control of hemorrhage symptoms and the time of bleeding stopped and bleeding again in the treatment group were superior to the control group（P〈0.05）.1, 2, 3 months after treatment,the PLT improvement of the treatment group were superior to the control group（P〈0.05）.There was no obvious adverse reaction of the treatment group,the control group had different degrees of hypertension （3 cases）,high blood sugar in 2 cases,1 case of stress ulcer,the incidence of adverse reactions was 24.00%.Conclusion：Tonifying Spleen Nourishing Liver Xiaodian Soup in combination with small dose of hormone treatment refractory idiopathic thrombocytopenic purpura,curative effect is good,and no obvious adverse reaction in the process of treatment,is worth further clinical application.

关 键 词：难治性血小板减少性紫癜 中西医结合 

分 类 号：R554.6[医药卫生—血液循环系统疾病]