升血小板胶囊联合泼尼松治疗血热妄行型原发性血小板减少症的临床研究  

Clinical study of Shengxuexiaoban Capsules combined with Prednisone in the treatment of primary ITP with hemopyretic bleeding type

作　　者：李正发[1,3] 赵晓晨 陆杨柳 毛瑞娇 陆俊蓉 代云 LI Zheng-fa;ZHAO Xiao-chen;LU Yang-liu(Department of Hematology,First People's Hospital of Yunnan Province,Kunming 650032,China)

机构地区：[1]云南省第一人民医院血液科(云南新昆华医院,云南省血液病医院,昆明理工大学附属医院),昆明650032 [2]云南中医药大学,昆明650032 [3]昆明理工大学医学院,昆明650034

出　　处：《医师在线》2023年第8期25-31,共7页Journal of Doctors Online

基　　金：云南省万人计划“名医”专项(YNWR-MY-2019-023);昆明市卫生技术中心专项[2020-SW(技)-32]。

摘　　要：目的探析升血小板胶囊联合醋酸泼尼松片对比单用醋酸泼尼松片治疗血热妄行型原发性血小板减少症(ITP)的临床疗效,以及对患者中医证候及出血评分的影响,拟为中成药联合激素治疗血热妄行型ITP提供参考。方法按纳入和排除标准选取2020年12月~2021年12月在云南省第一人民医院血液科门诊或住院的血热妄行型ITP患者72例,随机分为观察组和对照组,每组36例。观察组给予升血小板胶囊联合醋酸泼尼松片治疗,对照组给予醋酸泼尼松片治疗。同时根据ITP最新诊疗共识,在4周诊疗基础上间隔7 d后再复查血常规评价疗效。比较两组治疗前后综合疗效,以及中医证候分级量化标准评分、出血评分、肝肾功能和不良反应等。采用SPSS 26.0软件统计分析所收集的数据,得出结果并讨论其临床疗效和安全性。结果观察组脱落3例,对照组脱落2例,实际共完成67例。用药4周后,中医总有效率分别为84.85%、70.59%,观察组疗效优于对照组(P<0.05);西医总有效率分别为81.82%、67.65%,观察组效优(P<0.05)。治疗后,两组血小板计数均持续上升,观察组血小板升高趋势更加明显(P<0.05);两组出血评分下降,患者出血症状均得到改善;两组中医证候积分降低,观察组中医证候积分低于对照组(P<0.05)。两组治疗期间未发生肝功能、肾功能异常等不良反应。结论升血小板胶囊联合醋酸泼尼松片可明显升高辨证为血热妄行型的ITP患者的血小板计数,改善出血症状,降低ITP血热妄行型中医证候分级量化标准评分,对中医证候积分改善程度和总有效率优于单独应用泼尼松,且不良反应少,安全性高。Objective To explore the clinical efficacy of Shengxuexiaoban Capsules combined with Prednisone Acetate Tablets compared with Prednisone Acetate Tablets alone in the treatment of primary immune thrombocytopenia(ITP)with hemopyretic bleeding type,and the influence of traditional Chinese medicine(TCM)syndromes and bleeding scores of patients,so as to provide reference in the treatment of ITP with hemopyretic bleeding type with Chinese patent medicine combined with hormone.Methods According to the inclusion and exclusion criteria,72 ITP patients with hemopyretic bleeding type who were admitted to the Department of Hematology and Outpatient Department of the First People's Hospital of Yunnan Province from December 2020 to December 2021 were selected and randomly divided into observation group and control group,with 36 cases in each group.The observation group was treated with Shengxuexiaoban Capsules combined with Prednisone Acetate Tablets,and the control group was treated with Prednisone Acetate Tablets.According to the latest diagnosis and treatment consensus of ITP,the blood routine was reexamined after 7 days on the basis of 4 weeks of diagnosis and treatment to evaluate the curative effect.The comprehensive efficacy before and after treatment,as well as the quantitative standard score of TCM syndromes classification,bleeding score,liver and kidney function and adverse reactions were observed and compared between the two groups.SPSS 26.0 software was used for statistical analysis of the collected data,and the results were obtained and the clinical efficacy and safety were discussed.Results There were 3 cases in the observation group and 2 cases in the control group dropped out,and a total of 67 cases were actually completed.After 4 weeks of treatment,the total effective rates of TCM were 84.85%and 70.59%,respectively.The curative effect of the observation group was better than that of the control group(P<0.05).The total effective rates of western medicine were 81.82%and 67.65%,respectively,and the observation gr

关 键 词：升血小板胶囊 醋酸泼尼松片 免疫性血小板减少症 血热妄行 

分 类 号：R55[医药卫生—血液循环系统疾病]