银翘升板方辅助治疗风热伤络型原发免疫性血小板减少症35例随机对照研究  

Yinqiao Shengban Formula(银翘升板方)Adjuvant Therapy for Primary Immune Thrombocytopenia of 35 Cases:a Randomized Controlled Trial

作　　者：李睿嘉 王永敏[2] 李静[2] 张楠[2] 宋俊贞[3] 张倩倩[2] 王海妹 李晓红[2] LI Ruijia;WANG Yongmin;LI Jing;ZHANG Nan;SONG Junzhen;ZHANG Qianqian;WANG Haimei;LI Xiaohong(Graduate School,Hebei University of Chinese Medicine,Shijiazhuang,050200;Hebei Provincial Hospital of Traditional Chinese Medicine;Hebei Provincial Blood Center;Chengde Hospital of Traditional Chinese Medicine,Hebei Province)

机构地区：[1]河北中医学院研究生院,河北省石家庄市050200 [2]河北省中医院 [3]河北省血液中心 [4]河北省承德市中医院

出　　处：《中医杂志》2023年第9期924-929,共6页Journal of Traditional Chinese Medicine

基　　金：河北省中医药管理局科研计划项目(2020043)。

摘　　要：目的观察银翘升板方辅助治疗成人原发免疫性血小板减少症(ITP)风热伤络型的临床疗效。方法将74例ITP风热伤络型患者随机分为对照组和治疗组各37例,对照组给予泼尼松龙片1 mg/(kg·d)口服,或等效剂量的其他激素如甲泼尼龙片0.8 mg/(kg·d)口服,病情稳定后逐渐减量;治疗组在对照组基础上给予银翘升板方口服,每日1剂。两组均治疗8周后判定临床疗效及中医证候疗效。治疗前后比较两组患者血小板计数、出血症状评分、血栓弹力图关键参数[包括反应时间(R)、凝血时间(K)、最大振幅(MA)、综合凝血指数(CI)]。结果研究过程中对照组脱落4例,治疗组脱落2例,最终纳入本研究的患者为68例,其中治疗组35例,对照组33例。治疗组临床疗效总有效率为71.43%,中医证候疗效总有效率为74.29%,对照组分别为45.45%、30.30%,治疗组临床疗效和中医证候疗效均显著高于对照组(P<0.05或P<0.01)。与本组治疗前比较,两组患者治疗后血小板计数均升高、出血症状评分均降低,且治疗后治疗组患者血小板计数高于对照组、出血症状评分低于对照组(P<0.05或P<0.01)。两组患者血栓弹力图结果比较,MA、R、K值治疗前后差异均无统计学意义(P>0.05);两组患者治疗后CI值均较本组治疗前升高(P<0.05)。结论银翘升板方辅助治疗风热伤络型ITP临床疗效及中医证候疗效均优于单纯使用糖皮质激素药,可提升患者血小板计数,改善出血情况和低凝状态。Objective To explore the clinical effect of Yinqiao Shengban Formula(银翘升板方,YSF)adjuvant therapy for adult primary immune thrombocytopenia(ITP)with wind-heat damaging collaterals syndrome.Method Seventy-four ITP patients with wind-heat damaging collaterals syndrome were randomly divided into control group and treatment group,with 37 patients in each group.Both groups were treated with 0.8 mg/(kg·d)of oral prednisone tablet,or other hormones at an equivalent dose such as 0.8 mg/(kg·d)of oral methylprednisolone tablets,with reduced dosage as the condition gradually becomes stable;the treatment group additionally received YSF,one dose daily.After treatment of eight weeks,the clinical curative effect and effect regarding traditional Chinese medicine(TCM)symptoms were judged.The platelet count,bleeding score,and key parameters of thromboelastography including reaction time(R),coagulation time(K),maximum amplitude(MA)and coagulation index(CI)were compared between the two groups.Results Four cases in the control group and two cases in the control group dropped out during the study.Finally,68 cases were included involving 35 cases in the treatment gorup and 33 cases in the control group.The total clinical effective rate and the effect regarding TCM symptoms of the treatment group was 71.43%and 74.29%,respectively,significantly higher than 45.45%and 30.30%of the control group(P<0.05 or P<0.01).The improvement degree of TCM clinical efficacy and syndrome in the treatment group was much better than that in the control group(P<0.01).After treatment,the platelet count increased,while the bleeding score significantly decreased in both groups,and more changes were found in treatment group(P<0.05 or P<0.01).Thromboelastography showed no statistical significant difference in MA,R and K values before and after treatment(P>0.05);the CI value significantly decreased after treatment in both groups(P<0.05).Conclusion On the basis of modern medical treatment,the application of YSF in adjuvant to glucocorticoid has better eff

关 键 词：原发免疫性血小板减少症 紫癜病 风热伤络型 银翘升板方 血小板计数 凝血时间 血栓弹力图 

分 类 号：R259[医药卫生—中西医结合]