调补阴阳法治疗非重型再生障碍性贫血的临床观察  

Clinical Study on the Treatment of Non-severe Aplastic Anemia by Regulating and Tonifying“Yin and Yang”

作　　者：郑祥祥 林琳[2] 董雯 杨冉 沈群[2] ZHENG Xiang-xiang;LIN Lin;DONG wen;YANG Ran;SHEN Qun(Affiliated Hospital of Nanjing University of Chinese Medicine,Nanjing Jiangsu 210000;Department of Hematology,Jiangsu Provincial Hospital of Traditional Chinese Medicine,Nanjing Jiangsu 210029;Department of Hematology,Wuxi Hospital of Traditional Chinese Medicine,Wuxi Jiangsu 214001)

机构地区：[1]南京中医药大学附属医院,江苏南京210000 [2]江苏省中医院血液科,江苏南京210029 [3]无锡市中医院血液科,江苏无锡214001

出　　处：《世界中西医结合杂志》2022年第1期170-174,共5页World Journal of Integrated Traditional and Western Medicine

基　　金：江苏省中医药局科技项目(FY201702)。

摘　　要：目的探讨调补阴阳法治疗非重型再生障碍性贫血(Non-severe aplastic anemia,NSAA)的临床疗效、环孢素撤减情况以及对患者健康相关生活质量的影响。方法选取2017年12月—2019年6月期间就诊于江苏省中医院和安徽医科大学第一附属医院血液科的NSAA患者,共计83例,据治疗方法不同分为中西医治疗组和西药对照组,中西医治疗组根据辨证分型又分为肾阴虚组和肾阳虚组。西药对照组给予环孢素、十一酸睾酮胶丸口服治疗。中西医治疗组在西药对照组治疗的基础上给予补肾填精方加减。比较各组患者临床疗效、血常规、环孢素撤减情况和不良反应情况。结果治疗后中西医治疗组总有效率为75.9%(肾阴虚组总有效率为73.3%、肾阳虚组为78.6%),西药对照组为80.0%。3组比较,差异无统计学意义(P>0.05)。治疗后三组患者WBC、ANC、HGB、PLT均有不同程度地增高,与治疗前比较,西药对照组第3疗程后ANC、HGB、PLT明显增高,差异有统计学意义(P<0.05);肾阴虚组和肾阳虚组第2疗程后HGB、PLT明显增高,差异有统计学意义(P<0.05),第3疗程后WBC、ANC、HGB、PLT均明显增高,差异有统计学意义(P<0.05)。与西药对照组比较,肾阴虚组第3疗程后HGB、PLT均明显增高,差异有统计学意义(P<0.05),肾阳虚组ANC明显增高,差异有统计学意义(P<0.05)。治疗后肾阴虚组环孢素撤减率为63.6%,肾阳虚组为64.3%,西药对照组为36.0%。肾阴虚组和肾阳虚组环孢素撤减率明显高于西药对照组,差异有统计学意义(P<0.05)。治疗期间,3组患者耐受良好,无患者因不良反应停药或减量,与西药对照组比较,中西医治疗组的不良发生率较低,差异有统计学意义(P<0.05)。结论对于病程较长、环孢素撤减困难的NSAA患者,中西医结合和西药治疗均有一定疗效,但中西医结合治疗起效更早、环孢素撤减率高,能明显改善患者健康相关生活质量,安全性较好。Objective To investigate the clinical efficacy,withdrawal of cyclosporine and its effect on the health-related quality of life of patients with non-severe aplastic anemia(NSAA)treated with tonifying yin and yang method.Methods From December 2017 to June 2019,a total of 83 NSAA patients who were treated in the Department of Hematology of Jiangsu Provincial Hospital of Traditional Chinese Medicine and the First Affiliated Hospital of Anhui Medical University were selected.According to different treatment methods,they were divided into Chinese and Western medicine treatment group and Western medicine control group.The traditional Chinese and western medicine treatment group was further divided into kidney yin deficiency group and kidney yang deficiency group according to syndrome differentiation.The western medicine control group was given oral cyclosporine and testosterone undecanoate capsules.The traditional Chinese and western medicine treatment group was given the addition and subtraction of BushenBujing Formula on the basis of the western medicine control group.The clinical efficacy,blood routine,cyclosporine withdrawal and adverse reactions were compared in each group.Results After treatment,the total effective rate was 75.9%in the traditional Chinese and westernmedicine treatment group(73.3%in the kidney-yin deficiency group and 78.6%in the kidney-yang deficiency group),and 80.0%in the western medicine control group.There was no significant difference between the three groups(P>0.05).After treatment,WBC,ANC,HGB,and PLT in the three groups were increased to varying degrees.Compared with before treatment,ANC,HGB,and PLT in the western medicine control group were significantly increased after the third course of treatment,and the difference was statistically significant(P<0.05).After the second course of treatment,HGB and PLT in the kidney-yin deficiency group and kidney-yang deficiency group were significantly increased,and the difference was statistically significant(P<0.05).After the third course of treatment

关 键 词：再生障碍性贫血 调补阴阳法 补肾填精方 

分 类 号：R556[医药卫生—血液循环系统疾病]