复方皂矾丸联合茵陈蒿合归脾汤治疗阵发性睡眠性血红蛋白尿症的疗效观察  

Clinical Effect of Compound Zaofan Pills Combined with Yinchenhao and Guipi Decoctionon Treatment of Paroxysmal Nocturnal Hemoglobinuria

作　　者：王海南 孙艳舫 王会朋 杨淑莲 WANG Hai-nan;SUN Yan-fang;WANG Hui-peng;YANG Shu-lian(Langfang Hospital of Traditional Chinese Medicine,Langfang Hebei 065000)

机构地区：[1]廊坊市中医医院,河北廊坊065000

出　　处：《世界中西医结合杂志》2022年第9期1823-1827,1832,共6页World Journal of Integrated Traditional and Western Medicine

基　　金：2020年河北省中医药科研计划项目(2020441)。

摘　　要：目的观察复方皂矾丸联合茵陈蒿合归脾汤治疗阵发性睡眠性血红蛋白尿症(Paroxysmal nocturnal hemoglobinuria,PNH)的临床疗效及对患者造血功能的影响。方法选取2017年1月—2019年3月期间廊坊市中医医院收治的PNH患者64例,采用随机数字表法分为对照组和观察组,每组各32例。对照组采用醋酸泼尼松片等进行常规治疗,观察组基于杨淑莲教授临证经验,在对照组基础上加用复方皂矾丸、茵陈蒿汤合归脾汤。治疗16周后,观察比较两组患者临床疗效,两组患者治疗前后进行外周血细胞、血液生化分析,包括红细胞(Red blood cell,RBC)、白细胞(White blood cell,WBC)、血小板(Platelet,PLT)、血红蛋白(Hemoglobin,HGB)、红细胞平均体积(Mean corpuscular volume,MCV)、网织红细胞绝对值(Reticulocyte,Ret)、白蛋白(Albumin,ALB)、总胆红素(Total bilirubin,TBIL)、直接胆红素(Direct bilirubin,DBIL)、间接胆红素(Indirect bilirubin,IBIL)、乳酸脱氢酶(Lactate dehydrogenase,LDH)、促红细胞生成素(Erythropoietin,EPO)、转铁蛋白(Transferrin,Tf)、血清铁蛋白(Serum ferritin,SF)、血清铁(Serum iron,SI)以及转铁蛋白饱和度(Transferrin saturation,TSAT)。记录两组患者治疗期间不良反应发生情况。结果治疗后观察组总有效率96.88%(31/32)明显高于对照组81.25%(26/32),差异有统计学意义(P<0.05)。治疗后两组患者RBC、WBC、PLT、HGB水平均高于治疗前,MCV、Ret水平均低于治疗前,差异有统计学意义(P<0.05);且观察组RBC、HGB水平高于对照组,MCV、Ret水平均低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者ALB水平均高于治疗前,TBIL、IBIL、LDH、EPO水平均低于治疗前,差异均有统计学意义(P<0.05);且观察组ALB水平高于对照组,TBIL、IBIL、LDH、EPO水平均低于对照组,差异均有统计学意义(P<0.05);治疗后两组患者Tf、SF、SI、TSAT水平均高于治疗前,差异有统计学意义(P<0.05);且观察组高于对照组Objective To explore the effect of compound Zaofan Pills combined with Yinchenhao and Guipi Decoction on the treatment of paroxysmal nocturnal hemoglobinuria(PNH)and its influence on the hematopoietic function of patients.Methods Sixty-four patients with PNH admitted to Langfang Hospital of Traditional Chinese Medicine from January 2017 to March 2019 were included.All patients were divided into a control group(n=32)and an observation group(n=32)by the random number table method.The control group was given prednisone acetate tablets and other basic treatments,and the observation group was additionally given compound Zaofan Pills and Yinchenhao and Guipi Decoction based on the control group.After 16 weeks of treatment,the clinical efficacy of the two groups was observed.The peripheral blood cell and blood biochemical analysis before and after treatment in the two groups was performed,including the red blood cell(RBC),white blood cell(WBC),platelet(PLT),hemoglobin(HGB),mean corpuscular volume(MCV),reticulocyte(Ret),albumin(ALB),total bilirubin(TBIL),direct bilirubin(DBIL),indirect bilirubin(IBIL),lactate dehydrogenase(LDH),erythropoietin(EPO),transferrin(Tf),serum ferritin(SF),serum iron(SI),and transferrin saturation(TSAT).The occurrence of adverse reactions during the treatment of the two groups was recorded.Results After treatment,the total effective rate of the observation group was 96.88%(31/32)was higher than that of the control group[81.25%(26/32)](P<0.05).After treatment,the levels of RBC,WBC,PLT,and HGB in the two groups were higher than those before treatment,and the levels of MCV and Ret were lower than those before treatment(P<0.05).The levels of RBC and HGB in the observation group were higher than those in the control group,and the levels of MCV and Ret in the observation group were lower than those in the control group(P<0.05).After treatment,the level of ALB in the two groups was higher than those before treatment,and the levels of TBIL,IBIL,LDH,and EPO in the two groups were lower than those before

关 键 词：阵发性睡眠性血红蛋白尿症 复方皂矾丸 茵陈蒿汤 归脾汤 骨髓造血 

分 类 号：R552[医药卫生—血液循环系统疾病]