怡癜饮治疗儿童原发性免疫性血小板减少症的真实世界研究  

Yidianyin on primary immune thrombocytopenia in children:A real-world study

作　　者：张玉婷[1] 钟心媛 李达[2] 曹凤[1] 郑育涛 王沁[1] ZHANG Yuting;ZHONG Xinyuan;LI Da;CAO Feng;ZHENG Yutao;WANG Qin(Department of Rheumatology and Hematology,Zhuhai Hospital,Guangdong Provincial Hospital of Chinese Medicine,Zhuhai,Guangdong 519015;Department of Hematology,Guangdong Provincial Hospital of Chinese Medicine,Guangzhou,Guangdong 510000)

机构地区：[1]广东省中医院珠海医院风湿血液科,广东珠海519015 [2]广东省中医院血液科,广东广州510000

出　　处：《河北中医》2022年第10期1629-1633,共5页Hebei Journal of Traditional Chinese Medicine

基　　金：珠海市医学科研基金项目(编号:ZH3310200004PJL)。

摘　　要：目的观察真实世界中怡癜饮治疗儿童原发性免疫性血小板减少症(ITP)的疗效。方法采用临床回顾性研究方法,收集2017年1月至2019年1月广东省中医院血液科李达主任门诊就诊的符合病例选择标准的222例ITP患儿临床资料,根据患儿的实际治疗方案分为2组,中药组110例予怡癜饮辨证加减治疗,联合组112例予怡癜饮辨证加减联合西药常规治疗,均治疗6个月。比较2组临床疗效以及治疗前、治疗1个月和6个月后血小板计数(PLT)、出血评分。结果联合组总有效率33.93%(38/112),中药组22.73%(25/110),2组总有效率比较差异无统计学意义(P>0.05),2组疗效相当。中药组治疗1、6个月PLT较本组治疗前升高(P<0.05),治疗6个月较治疗1个月升高(P<0.05);治疗6个月出血评分与本组治疗前及治疗1个月比较差异均有统计学意义(P<0.05),治疗1个月与本组治疗前比较差异无统计学意义(P>0.05)。联合组治疗1、6个月PLT、出血评分与本组治疗前比较差异均有统计学意义(P<0.05),治疗6个月与治疗1个月比较差异均无统计学意义(P>0.05)。治疗1、6个月,2组PLT、出血评分组间比较差异均无统计学意义(P>0.05)。联合组112例中,65例患儿使用了糖皮质激素,治疗1个月激素减量患儿占47.7%,减停患儿占4.6%,治疗6个月分别为86.2%、44.6%。治疗1、6个月,65例患儿PLT和糖皮质激素用量与治疗前比较差异均有统计学意义(P<0.05);治疗6个月与治疗1个月PLT比较差异无统计学意义(P>0.05),激素用量比较差异有统计学意义(P<0.05)。结论怡癜饮能提升ITP患儿PLT,并改善出血症状,且能逐步减少ITP患儿糖皮质激素用量。Objective To observe the curative effect of Yidianyin on primary immune thrombocytopenia(ITP)in children in the real world.Methods In this retrospective study,children with primary ITP(n=222)who visited the outpatient clinic of Director Li Da of the Department of Hematology,Guangdong Provincial Hospital of Chinese Medicine from January 2017 to January 2019 were enrolled.The children were assigned to the traditional Chinese medicine(TCM)group(n=110)and the combination group(n=112)according to the actual therapeutic regimen;all patients were managed by modified Yidianyin,and the combination group additionally received conventional Western medicine.Treated for 6 months,the comparisons were made in platelet(PLT)count and bleeding risk score on day 0 and on months 1,6;the curative effect was assessed.Results The difference was not statistically significant in overall effective rate between the combination group and the TCM group(33.93%[38/112]vs 22.73%[25/110],respectively,[P>0.05]).PLT count on months 1,6 in the TCM group was increased than that on day 0(P<0.05),which on month 6 was increased compared with month 1(P<0.05).The difference was statistically significant in bleeding risk score of the TCM group between month 6 and day 0,and between month 6 and month 1(P<0.05),but the difference was not statistically significant between month 1 and day 0(P>0.05).There was significant difference being found in the comparison of PLT count and bleeding risk score of the combination group between month 1 and day 0,and between month 6 and day 0(all P<0.05),and no difference was significant between month 6 and month 1(P>0.05).None of the PLT count and bleeding risk score on months 1,6 differed significantly between groups(P>0.05).Totally 65 children of the combination group were treated with glucocorticoids,of which,the proportion of glucocorticoids reduction and glucocorticoids withdrawal were 47.7%and 4.6%on month 1,and 86.2%and 44.6%on month 6,respectively.The difference was statistically significant in the PLT and dosage of g

关 键 词：紫癜 血小板减少性 回顾性研究 中医疗法 

分 类 号：R558.205.31[医药卫生—血液循环系统疾病]