大菟丝子饮加减联合糖皮质激素治疗免疫性血小板减少性紫癜临床研究  

Clinical Study on Modified Datusizi Yin Combined with Glucocorticoid for Immunologic Thrombocytopenic Purpura

作　　者：权学莲[1] 刘春霞[1] 曹翠芳 范海燕 QUAN Xuelian;LIU Chunxia;CAO Cuifang;FAN Haiyan

机构地区：[1]廊坊市人民医院血液科,河北廊坊065000

出　　处：《新中医》2020年第20期56-59,共4页New Chinese Medicine

摘　　要：目的:观察大菟丝子饮加减联合糖皮质激素治疗免疫性血小板减少性紫癜(ITP)的疗效。方法:选取120例ITP患者,按照随机数字表法分为对照组和研究组各60例。对照组予以糖皮质激素治疗,研究组在对照组基础上加用大菟丝子饮加减治疗。观察并记录2组临床疗效、不良反应发生情况,比较2组治疗前后血小板计数、血小板相关免疫球蛋白(PAIgA、PAIgM、PAIgG)、T淋巴细胞亚群及相关血清炎症因子。结果:治疗后,2组白细胞介素(IL)-2、IL-2/IL-4、CD8+、GPⅡb/Ⅲa、GPⅠb/Ⅳ、PAIgA、PAIgM、PAIgG水平均降低(P<0.05),研究组上述指标较对照组治疗后更低(P<0.05);2组IL-4、CD3+、CD4+、CD4+/CD8+、血小板计数均升高(P<0.05),研究组上述指标较对照组治疗后更高(P<0.05)。研究组总有效率为91.67%,明显高于对照组的78.33%(P<0.05)。研究组不良反应总发生率为8.33%,低于对照组的21.67%(P<0.05),经积极对症处理后,2组不良反应均得以缓解。结论:大菟丝子饮加减联合糖皮质激素治疗ITP,能够有效降低患者血小板相关抗体,改善机体免疫功能,同时对因各种细胞信号激活引起的Th1/Th2免疫平衡失调临床疗效确切,安全可靠。Objective:To observe the curative effect of modified Datusizi yin combined with glucocorticoid for immunologic thrombocytopenic purpura(ITP).Methods:A total of 120 cases of ITP patients were selected and divided into the control group and the study group according to the random number table method,60 cases in each group.The control group was given glucocorticoid sequential therapy,and the study group was additionally treated with modified Datusizi yin based on the treatment of the control group.The clinical effect and the incidence of adverse reactions were observed and recorded in the two groups.Before and after treatment,the differences in platelet counts as well as the contents of PAIgA,PAIgM,PAIgG,T lymphocyte subsets and related inflammatory factors in serum were compared between the two groups.Results:After treatment,the levels of interleukin-2(IL-2),IL-2/IL-4,CD8^+,GPⅡb/Ⅲa,GPⅠb/Ⅳ,PAIgA,PAIgM and PAIgG in the two groups were decreased when compared with those before treatment(P<0.05),and the above indexes after treatment in the study group were lower than those in the control group(P<0.05).The levels of IL-4,CD3^+,CD4^+,CD4^+/CD8^+and platelet in the two groups were increased when compared with those before treatment(P<0.05),and the above indexes after treatment in the study group were higher than those in the control group(P<0.05).The total effective rate was91.67%in the study group,higher than that of 78.33%in the control group(P<0.05).The total incidence of adverse reactions was 8.33%in the study group,lower than that of 21.67%in the control group(P<0.05).After active and symptomatic treatments,the adverse reactions in the two groups were relieved.Conclusion:The therapy of modified Datusizi yin combined with glucocorticoid for ITP can effectively reduce platelet-related antibodies and improve immune function,which has defined clinical effect on Th1/Th2 immune imbalance induced by the activation of various cell signals,and safety.

关 键 词：免疫性血小板减少性紫癜 大菟丝子饮加减 血小板相关免疫球蛋白 Th1/Th2免疫平衡 

分 类 号：R544.6[医药卫生—心血管疾病]