补肾填精方联合西药治疗再生障碍性贫血血小板影响因素的预测研究  

Prediction of Platelet Influencing Factors in the Treatment of Aplastic Anemia by Bushen Tianjing Prescription Combined with Western Medicine

作　　者：刘健 张朝畅 张盛琪 王金环[3] 徐瑞荣[4] 杨淑莲 王涛[6] 刘奇峰[7] 王海霞[8] 孙岸弢[9] 沈建平[10] 许亚梅[11] 李建英 姚宇红 丁晓庆[14] 史哲新[15] 周永明[16] 胡琦[17] 申小惠[18] 许勇钢[2] 刘风[2] 麻柔[2] 唐旭东[2] LIU Jian;ZHANG Chaochang;ZHANG Shengqi;WANG Jinhuan;XU Ruirong;YANG Shulian;WANG Tao;LIU Qifeng;WANG Haixia;SUN Antao;SHEN Jianping;XU Yamei;LI Jianying;YAO Yuhong;DING Xiaoqing;SHI Zhexin;ZHOU Yongming;HU Qi;SHEN Xiaohui;XU Yonggang;LIU Feng;MA Rou;TANG Xudong(Graduate School of Beijing University of Chinese Medicine,Beijing 100029,China;Hematology Department,Xiyuan Hospital,China Academy of Chinese Medical Sciences,Beijing 100091,China;The First Affiliated Hospital of Heilongjiang University of Chinese Medicine,Harbin 150000,China;Affiliated Hospital of Shandong University of Traditional Chinese Medicine,Ji′nan 250000,China;Langfang Traditional Chinese Medicine Hospital,Langfang 065000,China;The First Affiliated Hospital of Henan University of Chinese Medicine,Zhengzhou 450000,China;Jilin Province People′s Hospital,Changchun 130000,China;Affiliated Hospital of Weifang Medical University,Weifang 261000,China;Guang′anmen Hospital,China Academy of Chinese Medical Sciences,Beijing 100032,China;Zhejiang Provincial Hospital of Chinese Medicine,Hangzhou 310000,China;Dongzhimen Hospital,Beijing University of Chinese Medicine,Beijing 100007,China;Shijiazhuang Ping′an Hospital,Shijiazhuang 050000,China;The Second Affiliated Hospital of Guizhou University of Traditional Chinese Medicine,Guiyang 550000,China;Dongfang Hospital,Beijing University of Chinese Medicine,Beijing 100071,China;The First Affiliated Hospital of Tianjin University of Traditional Chinese Medicine,Tianjin 300000,China;Yueyang Hospital,Shanghai University of Traditional Chinese Medicine,Shanghai 200080,China;Shanghai Municipal Hospital of Traditional Chinese Medicine,Shanghai 200040,China;Gansu Provincial Hospital of Traditional Chinese Medicine,Lanzhou 730000,China)

机构地区：[1]北京中医药大学研究生院,北京100029 [2]中国中医科学院西苑医院血液科,北京100091 [3]黑龙江中医药大学附属第一医院,哈尔滨150000 [4]山东中医药大学附属医院,济南250000 [5]廊坊市中医医院,廊坊065000 [6]河南中医药大学第一附属医院,郑州450000 [7]吉林省人民医院,长春130000 [8]潍坊医学院附属医院,潍坊261000 [9]中国中医科学院广安门医院,北京100032 [10]浙江省中医院,杭州310000 [11]北京中医药大学东直门医院,北京100007 [12]石家庄平安医院,石家庄050000 [13]贵州中医药大学第二附属医院,贵阳550000 [14]北京中医药大学东方医院,北京100071 [15]天津中医药大学第一附属医院,天津300000 [16]上海中医药大学附属岳阳医院,上海200080 [17]上海市中医医院,上海200040 [18]甘肃省中医院,兰州730000

出　　处：《世界中医药》2023年第12期1708-1714,共7页World Chinese Medicine

基　　金：国家自然科学基金面上项目(82074258);国家中医药管理局中医药行业科研专项(201507001-13);中国中医科学院科技创新工程重大攻关项目(CI2021A01701)。

摘　　要：目的:观察补肾填精方联合西药治疗再生障碍性贫血(AA)对血小板(PLT)的影响,分析影响PLT的临床因素特征。方法:选取2018年9月至2021年3月中国中医科学院西苑医院、广安门医院等19个分中心的AA患者79例作为研究对象,以补肾填精方联合西药基础治疗,连用3个月为1个疗程,连续服用2个疗程,观察患者PLT变化情况,分析PLT较基线值增长且恢复正常、较基线值增长未恢复正常的AA患者的临床因素特征。结果:AA患者接受补肾填精方联合西药治疗4个月后,PLT较基线值增长且恢复正常的有13例,PLT较基线值增长未恢复正常的有66例。对一般资料分析显示,中医证候积分越低,补肾填精方联合西药治疗,PLT越容易恢复正常(P<0.05)。对治疗前血常规分析结果显示,治疗前血红蛋白≥60 g/L时、中性粒细胞数值越高时、网织红细胞比率<0.5%时,补肾填精方联合西药治疗,PLT越容易恢复正常(P<0.05)。对治疗前T淋巴细胞亚群结果分析显示,CD3^(+)CD19^(-)<60%时,以补肾填精方联合西药治疗,PLT更容易恢复正常(P<0.05)。结论:当AA患者的中医证候积分越低、血红蛋白≥60 g/L、中性粒细胞数值越高、网织红细胞比率<0.5%、CD3^(+)CD19^(-)<60%且越低时,以补肾填精方联合西药治疗,AA患者的PLT更容易增加并恢复正常(P<0.05)。Objective:To observe the effects of the Bushen Tianjing Prescription combined with western medicine on platelet(PLT)levels in patients with aplastic anemia(AA)and analyze the clinical factors influencing PLT.Methods:Seventy-nine AA patients from 19 participating centers,including Xiyuan Hospital and Guang′anmen Hospital of China Academy of Chinese Medical Sciences from September 2018 to March 2021 were enrolled.The patients received Bushen Tianjing Prescription combined with western medicine as the basic treatment.Each treatment course lasted three months,and the patients received two consecutive courses.The changes in PLT levels were observed,and the clinical factors of AA patients whose PLT increased from baseline and returned to normal and did not return to normal from baseline were analyzed.Results:After four months of treatment with Bushen Tianjing Prescription combined with western medicine,13 patients showed an increase in PLT levels that returned to normal,while 66 patients showed an increase in PLT levels but did not return to normal.General data analysis showed that the lower the traditional Chinese medicine(TCM)syndrome score,the easier the PLT recovery to normal with the treatment of Bushen Tianjing Prescription combined with western medicine(P<0.05).Pre-treatment blood routine analysis results indicated that when the hemoglobin level was≥60 g/L and the reticulocyte percentage was<0.5%,the higher the neutrophil count,the treatment with the Bushen Tianjing Prescription combined with western medicine resulted in a higher chance of PLT recovery to normal(P<0.05).The analysis of pre-treatment T lymphocyte subsets showed that when CD3^(+)CD19^(-)was<60%,the treatment with the Bushen Tianjing Prescription combined with western medicine resulted in a higher chance of PLT recovery to normal(P<0.05).Conclusion:For AA patients,a lower TCM syndrome score,hemoglobin level≥60 g/L,higher neutrophil count,reticulocyte percentage<0.5%,and CD3^(+)CD19^(-)<60%are associated with a higher likelihood of PLT increas

关 键 词：再生障碍性贫血 补肾填精方 中西医结合治疗 血小板 影响因素 临床指标 预测研究 临床试验 

分 类 号：R556.5[医药卫生—血液循环系统疾病]