黄芪建中汤加味在原发免疫性血小板减少症治疗中的临床效果及对患者T淋巴细胞亚群水平、复发率的影响  

Effectiveness analysis of modified Huangqi Jianzhong Decoction in the treatment of primary immune thrombocytopenia and its effect on the level of T lymphocyte subsets and recurrence rate

作　　者：马西虎[1] 吴雪琴[1] 李巍[1] 刘伟[1] MA Xi-hu;WU Xue-qin;LI Wei(Department of Hematolog,Affiliated Traditional Chinese Medicine Hospital of Xinjiang Medical University,Urumqi Xinjiang 830000,China)

机构地区：[1]新疆医科大学附属中医医院血液科,新疆乌鲁木齐830000

出　　处：《临床和实验医学杂志》2022年第15期1608-1611,共4页Journal of Clinical and Experimental Medicine

基　　金：新疆维吾尔自治区自然科学基金(编号:2016D01C146)。

摘　　要：目的 探讨黄芪建中汤加味在原发免疫性血小板减少症治疗中的临床效果及对患者T淋巴细胞亚群水平、复发率的影响。方法 回顾性分析2016年3月至2021年3月于新疆医科大学附属中医医院治疗的48例原发免疫性血小板减少症患者的临床资料,依照治疗方法的不同分为两组,其中接受糖皮质激素治疗的24例患者设为常规组,在糖皮质激素治疗基础上接受黄芪建中汤加味治疗的24例患者设为研究组。分析对比两组患者治疗的总有效率、复发率、不良反应发生率、血小板数量变化情况,以及达到疗效的时间。同时对患者治疗前后T淋巴细胞亚群水平进行比较分析。结果 相较于常规组,研究组治疗总有效率明显更高(87.50%vs. 62.50%),停药后研究组的复发率明显更低(20.83%vs. 50.00%),差异均有统计学意义(P <0.05)。相较于常规组,研究组治疗后血小板升高的中位数明显更高[(155.12±47.29)×10^(9)/L vs.(69.18±33.20)×10^(9)/L],即便停药1个月血小板数值依旧更高[(135.29±31.67)×10^(9)/L vs.(106.39±34.20)×10^(9)/L],达到有效的时间明显更短[(6.39±1.28) d vs.(9.73±2.03) d],差异均有统计学意义(P <0.05)。治疗后,两组T淋巴细胞亚群CD3^(+)、CD4^(+)水平均明显升高,CD8^(+)下降,且相较于常规组,研究组CD3^(+)、CD4^(+)水平更高[(74.03±3.42)%vs.(70.02±3.16)%,(41.15±2.87)%vs.(37.90±3.08)%],CD8^(+)水平更低[(26.10±3.17)%vs.(29.31±3.10)%],差异均有统计学意义(P <0.05)。两组不良反应发生率比较,差异无统计学意义(P> 0.05)。结论 在原发免疫性血小板减少症治疗中应用黄芪建中汤加味治疗可显著提高患者的治疗效果,改善机体免疫功能,提高血小板数值,同时还能降低复发率,具有极高的临床应用价值。Objective To explore the effectiveness of modified Huangqi Jianzhong Decoction in the treatment of primary immune thrombocytopenia and its effect on the level of T lymphocyte subsets and recurrence rate.Methods The clinical data of 48 patients with primary immune thrombocytopenia treated in the Affiliated Traditional Chinese Medicine Hospital of Xinjiang Medical University from March 2016 to March 2021 were retrospectively analyzed.They were divided into two groups according to different treatment methods,including 24 patients treated with glucocorticoid as the routine group and 24 patients treated with modified Huangqi Jianzhong Decoction on the basis of glucocorticoid as the research group.The total effective rate,recurrence rate,incidence of adverse reactions,changes in the number of platelets and the time to achieve the curative effect were analyzed and compared between the two groups.At the same time,the levels of T lymphocyte subsets and serum inflammatory factors before and after treatment were compared and analyzed.Results Compared with the routine group,the total effective rate of the research group was significantly higher(87.50%vs.62.50%),and the recurrence rate of the research group was significantly lower after drug withdrawal(20.83%vs.50.00%),the differences were statistically significant(P<0.05).Compared with the routine group,the median of platelet elevation in the research group was significantly higher after treatment[(155.12±47.29)×10^(9)/L vs.(69.18±33.20)×10^(9)/L],and the platelet value was still higher even after one month of drug withdrawal[(135.29±31.67)×10^(9)/L vs.(106.39±34.20)×10^(9)/L],and the effective time was significantly shorter[(6.39±1.28)d vs.(9.73±2.03)d],the differences were statistically significant(P<0.05).After treatment,the levels of CD3^(+)and CD4^(+)of T lymphocyte subsets in the two groups increased significantly,while CD8^(+)decreased,and compared with the conventional group,the levels of CD3^(+)and CD4^(+)in the research group were higher[(74.03±3.42)%vs.

关 键 词：原发免疫性血小板减少症 黄芪建中汤加味 T淋巴细胞亚群 疗效 

分 类 号：R558.2[医药卫生—血液循环系统疾病]