归脾汤加减治疗免疫性血小板减少症临床研究  

Clinical Study of Modified Guipi Tang Treatment of Immune Throm-bocytopenic Purpura with Qi Failing to Control Blood

作　　者：吕晓娟[1] 覃骏[1] 柯鸿[1] 龚晓丽[1] 

机构地区：[1]十堰市人民医院,湖北十堰442000

出　　处：《中医学报》2016年第8期1178-1181,共4页Acta Chinese Medicine

基　　金：湖北中医药管理医学科研项目(201403048)

摘　　要：目的:观察归脾汤加减治疗免疫性血小板减少症气不摄血证的临床疗效。方法:将100例免疫性血小板减少症患者采用随机数字表法分为对照组和治疗组,每组50例。对照组口服泼尼松治疗;治疗组在对照组治疗基础上加服归脾汤加减治疗,药物组成:白术、太子参、黄芪、当归、远志、赤芍、白芍各15 g,雷公藤、茯神、柴胡、丹参、牡丹皮各10 g,白茅根、水牛角30 g,炙甘草9 g。两组患者均治疗3个月。比较两组患者治疗前后血小板恢复情况,检测治疗前后两组患者血CD_4^+、CD_(25)^+、Treg细胞百分比及血清白细胞介素-10(interleukin-10,IL-10)、白细胞介素-17(interleukin-17,IL-17)水平,比较治疗后两组患者的临床疗效,并记录两组患者不良反应发生情况。结果:治疗后治疗组临床有效率为62%,高于对照组的36%,差异有统计学意义(χ~2=6.76,P<0.01);治疗后治疗组血小板计数及Treg细胞百分比均上调,并高于对照组,差异有统计学意义(P<0.01);治疗后,治疗组IL-17、IL-10水平提高,并高于对照组,差异有统计学意义(P<0.05);治疗组不良反应发生情况明显较对照组少,差异有统计学意义(P<0.01)。结论:归脾汤加减治疗免疫性血小板减少症能迅速提高患者血小板水平,通过改变Treg细胞数量和调节其功能,提高自身免疫功能,缓解西药治疗带来的不良反应,临床疗效显著。Objective ： To observe the clinical curative effect of modified Guipi Tang treatment of immune throm-bocytopenic purpura. Methods ：100 patients with immune throm-bocytopenic purpura were randomly divided into the control group and the treatment group,50 cases in each group. The control group was treated with prednisone and the treatment group was treated with modified Guipi Tang, composition： Baizhu （ Atractylodes ） 15 g, Taizishen （ Radix Pseudostellariae） 15 g, Huangqi （Astragalus） 15 g, Danggui （ Chinses Angelica） 15 g, Yuanzhi （ Polygala Root） 15 g, Chishao （ Red Peony Root） 15 g, Baishao （ White Peony Root） 15 g, Leigongteng （ Tripterygium wilfordii） 10 g, Fushen （Poria） I0 g, Chaihu （ Bupleurum ） 10 g, Danshen （ Salvia Miltiorrhiza ） 10 g, Mudanpi （ Peony Bark） 10 g, Baimaogen （ Rhizoma Imperatae） 30 g, Shuiniujiao （ Cornu Bubali ） 30 g, Zhiganeao （Licorice） 9 g. The patients in the two groups were all treated for 3 months. Compared platelet recovery of the two groups before and after treatment, detected CD4 ^＋ CD25 ^＋ Treg cell percentage and serum interleukin 10 （ IL-10 ）, interleukin-17 intedeukin-17 （ IL-17 ） levels, compared the clinical efficacy of the two groups of patients after treatment and recorded the occurrence of adverse reactions of the two groups of patients. Results：After treatment, clinical efficiency of the treatment group was 62%, higher than the control group of 36%, the difference was statistically significant （χ^2 = 6.76, P 〈 0.01 ） ; after treatment, PLT count and Treg cell percentage were raised, which were higher than those in the control group, the difference was statistically significant（P 〈0.01 ） ;after the course of treatment, the treatment group IL-17, IL-IO levels increased, and higher than the control group, the difference was statistically significant（ P 〈 0. 05 ） ; the incidence of adverse reactions in the treatment group was sigttificantly less than the control group, the di

关 键 词：免疫性血小板减少症 归脾汤 泼尼松 中医药疗法 中西医结合 

分 类 号：R259.552[医药卫生—中西医结合]