紫癜汤治疗糖皮质激素无效的阴虚火旺证ITP临床观察  

Clinical observation on Purpura Decoction in the treatment of primary immune thrombocytopenia with hyperactivity of fire syndrome due to yin deficiency irresponsive to glucocorticoid therapy

作　　者：夏芸芸[1] 马立明[1] 陈苏宁[2] XIA Yun-yun;MA Li-ming;CHEN Su-ning(Department of Hematology,Affiliated Hospital of Liaoning University of Traditional Chinese Medicine,Shenyang 110032,China;Department of Traditional Chinese Medicine,Shengjing Hospital of China Medical University,Shenyang 110004,China)

机构地区：[1]辽宁中医药大学附属医院血液科,辽宁沈阳110032 [2]中国医科大学附属盛京医院中医科,辽宁沈阳110004

出　　处：《实用药物与临床》2021年第1期53-57,共5页Practical Pharmacy and Clinical Remedies

基　　金：第六批全国老中医药专家学术经验继承人项目[国中医药办人教函(2017)125](2017-432)。

摘　　要：目的观察紫癜汤治疗应用糖皮质激素无效的阴虚火旺证原发性免疫性血小板减少症的临床疗效。方法收集2017年1月至2019年11月于辽宁中医药大学附属医院血液科病房住院的应用糖皮质激素治疗无效的阴虚火旺证原发性免疫性血小板减少症患者62例,随机分成治疗组与对照组,每组31例。对照组采用重组人促血小板生成素治疗,必要时输注血小板及加用止血药物;治疗组在上述基础上加用中药汤剂紫癜汤口服。两组治疗时间均为14 d。观察记录治疗组与对照组的治疗前、治疗后第7天、治疗后第14天血小板计数,治疗前后皮肤、黏膜及深部器官出血情况。结果治疗14 d后,治疗组与对照组的总有效率分别为64.52%、45.16%(P>0.05);治疗后第7天,治疗组血小板计数稍高(P>0.05);治疗后第14天,治疗组血小板计数升高明显(P<0.05),并且出血情况缓解明显(P<0.05)。结论紫癜汤能显著改善糖皮质激素治疗无效的阴虚火旺证原发性免疫性血小板减少症患者的出血症状,增加其血小板计数,疗效可靠。Objective To observe the clinical effect of Purpura Decoction in the treatment of primary immune thrombocytopenia(ITP)with hyperactivity of fire syndrome due to yin deficiency irresponsive to glucocorticoid therapy.Methods A total of 62 patients with ITP and hyperactivity of fire syndrome due to yin deficiency irresponsive to glucocorticoid therapy were collected in the wards of the Hematology Department of Affiliated Hospital of Liaoning University of Traditional Chinese Medicine from January 2017 to December 2019.They were randomly divided into treatment group and control group,with 31 cases in each group.Both groups were treated with rhTPO,and transfusions and hemostatics if necessary,while the treatment group was also treated with Purpura Decoction.The treatment lasted for 14 days.Record platelet counts before treatment and on the 7th and 14th day after treatment,and observe the bleeding of skin,mucous membranes and viscera before and after treatment.Results The total effective rates of the treatment group and the control group were 64.52%and 45.16%after 14 days of treatment(P>0.05).Platelet counts in the treatment group were a little higher on the 7th day after treatment(P>0.05).Platelet counts went much higher(P<0.05)and the bleeding was relieved more obviously(P<0.05)in the treatment group on the 14th day after treatment.Conclusion Purpura Decoction can significantly relieve bleeding symptoms and increase platelet counts of patients suffering from ITP with hyperactivity of fire syndrome due to yin deficiency irresponsive to glucocorticoid therapy.

关 键 词：紫癜汤 原发性免疫性血小板减少症 糖皮质激素治疗无效 阴虚火旺证 

分 类 号：R259[医药卫生—中西医结合]