凉血散血方联合醋酸泼尼松片治疗特发性血小板减少性紫癜35例总结  

Clinical effect of Liangxue Sanxue prescription combined with prednisone acetate tablets in treatment of idiopathic thrombocytopenic purpura: An analysis of 35 cases

作　　者：张薇薇[1] ZHANG Weiwei(Hunan Provincial People’s Hospital,Changsha 410005,Hunan,China)

机构地区：[1]湖南省人民医院,湖南长沙410005

出　　处：《湖南中医杂志》2021年第7期8-11,共4页Hunan Journal of Traditional Chinese Medicine

基　　金：湖南省中医药科研计划项目(2015157)。

摘　　要：目的:观察凉血散血方联合醋酸泼尼松片治疗特发性血小板减少性紫癜(ITP)的疗效。方法:将78例ITP患者随机分为治疗组和对照组,每组各39例,最终完成研究57例,其中治疗组35例,对照组22例。对照组采用醋酸泼尼松片治疗,治疗组在对照组的基础上加用凉血散血方治疗。比较2组临床疗效、治疗前后血小板计数、血小板相关免疫球蛋白(PAIgA、PAIgM、PAIgG)水平、外周血单核细胞共刺激分子CD40、CD40L、OX40、OX40L mRNA表达水平及不良反应发生情况。结果:总有效率治疗组为88.57%(31/35),明显高于对照组的68.18%(15/22),差异有统计学意义(P<0.05)。治疗后,2组血小板计数均升高,且治疗组升高幅度较对照组大,差异均有统计学意义(P<0.05);2组PAIgA、PAIgM、PAIgG水平均降低,且治疗组PAIgA、PAIgM较对照组下降幅度大,差异均有统计学意义(P<0.05);治疗组CD40、CD40L、OX40、OX40L mRNA,表达低于对照组,差异有统计学意义(P<0.05)。不良反应发生率治疗组为8.58%(3/35),对照组为18.18%(4/22),2组差异有统计学意义(P<0.05)。结论:凉血散血方联合醋酸泼尼松片治疗ITP临床疗效确切,毒副作用小,能够有效降低患者血小板相关抗体,改善机体免疫功能,同时能抑制外周血单核细胞共刺激分子的表达。Objective: To investigate the clinical effect of Liangxue Sanxue prescription combined with prednisone acetate tablets in the treatment of idiopathic thrombocytopenic purpura(ITP).Methods: A total of 78 patients with ITP were randomly divided into treatment group and control group, with 39 patients in each group, and finally 57 patients completed the treatment, with 35 patients in the treatment group and 22 in the control group.The patients in the control group were given prednisone acetate tablets, and those in the treatment group were given Liangxue Sanxue prescription in addition to the treatment in the control group.The two groups were compared in terms of clinical outcome, platelet count, platelet-associated immunoglobulins(PAIgA,PAIgM,and PAIgG),mRNA expression level of costimulatory molecules(CD40,CD40 L,OX40 and OX40 L) in peripheral blood mononuclear cells, and adverse reactions.Results: The treatment group had a significantly higher overall response rate than the control group [88.57%(31/35) vs 68.18%(15/22),P<0.05].After treatment, both groups had a significant increase in platelet count, and the treatment group had a significantly greater increase than the control group(P<0.05);both groups had significant reductions in the levels of PAIgA,PAIgM,and PAIgG,and the treatment group had significantly greater reductions in PAIgA and PAIgM than the control group(P<0.05);the treatment group had significantly mRNA lower expression levels of CD40,CD40,OX40 and OX40 L than the control group(P<0.05).There was a significant difference in the incidence rate of adverse events between the treatment group and the control group [8.58%(3/35) vs 18.18%(4/22),P<0.05].Conclusion: Liangxue Sanxue prescription combined with prednisone acetate tablets has a marked clinical effect in the treatment of ITP,with little toxic and side effects, and can effectively reduce platelet-associated antibodies, improve immune function, and inhibit the expression of costimulatory molecules in peripheral blood mononuclear cells.

关 键 词：特发性血小板减少性紫癜 中西医结合疗法 凉血散血方 醋酸泼尼松片 

分 类 号：R275.982.9[医药卫生—中西医结合]