六味地黄汤加减对血液透析肝肾阴虚型血小板减少症患者微炎症状态、血管通路功能及血清GPⅡb、PMPs和PAIg的影响  

Effects of Modified Liuwei Dihuang Decoction on Micro-Inflammatory State,Vascular Access Function and Serum GPⅡb,PMPs and PAIg Levels in Patients with Thrombocytopenia of Liver and Kidney Yin Deficiency Type in Hemodialysis

作　　者：曹蓉 魏华娟[1] 孙珊珊[1] 秦娜 刘伟花 李叶[1] CAO Rong;WEI Huajuan;SUN Shanshan;QIN Na;LIU Weihua;LI Ye(Dept.of Nephrology,Shijiazhuang Hospital of Traditional Chinese Medicine,Shijiazhuang 050000,China)

机构地区：[1]石家庄市中医院肾病科,石家庄050000

出　　处：《中国医院用药评价与分析》2024年第10期1212-1216,共5页Evaluation and Analysis of Drug-use in Hospitals of China

基　　金：河北省中医药管理局中医药科研计划项目(No.2019429)。

摘　　要：目的:观察六味地黄汤加减对血液透析肝肾阴虚型血小板减少症患者微炎症状态、血管通路功能及血清血小板膜糖蛋白(GPⅡb)、血小板微颗粒(PMPs)和血小板相关免疫球蛋白(PAIg)水平的影响。方法:选择2020年4月至2023年4月该院收治的血液透析肝肾阴虚型血小板减少症患者120例,根据随机数字表法分为观察组及对照组。对照组60例患者给予常规西医治疗,观察组60例患者在对照组的基础上给予六味地黄汤加减治疗。治疗前后检测两组患者Th17/Treg细胞比例、PAIg、GPⅡb、PMPs、高迁移率族蛋白B1(HMGB1)、血小板活化因子(PAF)、白细胞介素10(IL-10)、血栓调节蛋白(TM)、血小板生成素(TPO)、P-选择素(CD62P)、脂蛋白相关磷脂酶A2(Lp-PLA2)和血小板计数(PLT)水平,并计算血小板压积(PCT)、血红蛋白、总胆红素水平,比较两组患者的临床疗效及不良反应发生情况。结果:本研究无脱落病例。治疗后,观察组患者的Th17/Treg、HMGB1、Lp-PLA2、PAF、CD62P、TM、GPⅡb、PMPs、PAIg、TPO、白细胞总数和总胆红素水平较对照组明显降低,IL-10、PLT、PCT和血红蛋白水平较对照组明显升高,差异均有统计学意义(P<0.05)。观察组患者的总有效率为96.67%(58/60),较对照组的86.67%(52/60)明显更高,差异有统计学意义(P<0.05)。治疗期间,两组患者均无明显不良反应产生。结论:六味地黄汤加减治疗血液透析肝肾阴虚型血小板减少症患者,可调节患者机体免疫,改善微炎症状态及血管通路功能,降低GPⅡb、PMPs和PAIg水平,改善血小板水平,调节白细胞总数、总胆红素和血红蛋白水平,提高临床疗效,安全性高。OBJECTIVE:To observe the effects of modified Liuwei Dihuang decoction on micro-inflammatory state,vascular access function and serum platelet membrane glycoprotein(GPⅡb),platelet microparticles(PMPs)and platelet-associated immunoglobulin(PAIg)levels in patients with thrombocytopenia of liver and kidney Yin deficiency type in hemodialysis.METHODS:A total of 120 patients with thrombocytopenia of liver and kidney Yin deficiency type in hemodialysis admitted into the hospital from Apr.2020 to Apr.2023 were extracted to be divided into the observation group and control group through the random number table method,with 60 cases in each group.The control group was given conventional Western medicine treatment,while the observation group received modified Liuwei Dihuang decoction based on the control group.The proportion of Th17/Treg cells,PAIg,GPⅡb,PMPs and high mobility group protein B1(HMGB1),platelet activating factor(PAF),interleukin-10(IL-10),thrombomodulin(TM),thrombopoietin(TPO),P-selectin(CD62P),lipoprotein-associated phospholipase A2(Lp-PLA2),platelet count(PLT)levels in both groups were detected before and after treatment.The levels of platelet pressure(PCT),hemoglobin and total bilirubin were calculated.The clinical efficacy and adverse drug reactions were compared between two groups.RESULTS:There was no drop-out cases.After treatment,Th17/Treg,HMGB1,Lp-PLA2,PAF,CD62P,TM,GPⅡb,PMPs,PAIg,TPO,WBC and total bilirubin levels in the observation group were significantly lower than those in control group,and IL-10,PLT,PCT and hemoglobin in observation group were significantly higher than those in control group,with statistically significant differences(P<0.05).The total effective rate of observation group was 96.67%(58/60),significantly higher than 86.67%(52/60)of control group,the difference was statistically significant(P<0.05).During treatment,no obvious adverse drug reactions occurred in both groups.CONCLUSIONS:Modified Liuwei Dihuang decoction in the treatment of patients with thrombocytopenia of liver and

关 键 词：六味地黄汤加减 血液透析 血小板减少症 微炎症状态 血管通路功能 血小板相关免疫球蛋白 

分 类 号：R932[医药卫生—生药学]