活血解毒方治疗真性红细胞增多症热毒血瘀证临床研究  

Clinical Study on the Huoxue Jiedu Prescription for the Treatment of Polycythemia Vera with Heat Toxicity and Blood Stasis Syndrome

作　　者：赵玉敏 张宇梁 王国姿 赵朋敏 赵蒙军 刘希赞 李朝霞 邸海侠(指导) ZHAO Yumin;ZHANG Yuliang;WANG Guozi;ZHAO Pengmin;ZHAO Mengjun;LIU Xizan;LI Zhaoxia;DI Haixia(Instructor)(Hebei North University,Zhangjiakou 075000,China;Langfang Traditional Chinese Medicine Hospital,Langfang 065000,China)

机构地区：[1]河北北方学院,河北张家口075000 [2]廊坊市中医医院,河北廊坊065000

出　　处：《中国中医药信息杂志》2025年第4期141-145,共5页Chinese Journal of Information on Traditional Chinese Medicine

基　　金：中国民族医药学会科研项目(2020ZY175-440801);中华中医药学会科研项目(202169-003);国家中医药管理局杨淑莲全国名老中医药专家传承工作室建设项目(2022年);2023年河北省研究生创新资助项目(PX-19221895);京津冀中医药协同专科联盟(2024年)。

摘　　要：目的评价活血解毒方治疗真性红细胞增多症热毒血瘀证的临床疗效和安全性。方法收集2022年10月-2024年3月廊坊市中医医院等5家医院真性红细胞增多症热毒血瘀证患者155例,采用随机数字表法分为观察组(79例)和对照组(76例),2组均予常规西药治疗,观察组并予活血解毒方,每日1剂,每日2次,口服;2组均以1个月为1个疗程,观察3个疗程。观察2组西医疗效及中医证候疗效,比较2组治疗前后骨髓增殖性肿瘤总症状评估量表(MPN-10)评分、血常规、凝血功能,监测2组安全性指标。结果对照组、观察组分别脱落2、4例。观察组西医疗效总有效率为90.67%(68/75),对照组为67.57%(50/74),2组比较差异有统计学意义(P<0.01);观察组中医证候疗效总有效率为94.67%(71/75),对照组为71.62%(53/74),2组比较差异有统计学意义(P<0.01)。与本组治疗前比较,2组MPN-10总分显著下降(P<0.05);2组治疗后比较,观察组MPN-10总分低于对照组(P<0.05)。与本组治疗前比较,2组治疗后血红蛋白、白细胞计数、血细胞比容、血小板计数均显著降低(P<0.05);2组治疗后比较,观察组上述血常规指标均优于对照组(P<0.05)。与本组治疗前比较,2组治疗后D-二聚体、纤维蛋白原水平显著降低,活化部分凝血活酶时间及凝血酶原时间显著缩短(P<0.05);2组治疗后比较,观察组上述凝血功能指标改善程度均优于对照组(P<0.05)。2组未出现明显不良反应。结论活血解毒方治疗真性红细胞增多症热毒血瘀证可提高临床疗效,改善血液学指标,降低凝血功能指标,且安全性良好。Objective To evaluate the clinical efficacy and safety of Huoxue Jiedu Prescription in the treatment of polycythemia vera with heat toxicity and blood stasis syndrome.Methods Totally 155 patients of polycythemia vera with heat toxicity and blood stasis syndrome from 5 hospitals including Langfang Traditional Chinese Medicine Hospital from October 2022 to March 2024 were collected.Patients were divided into an observation group(79 cases)and control group(76 cases)using a random number table method.Both groups received conventional Western medicine treatment.The observation group was given Huoxue Jiedu Prescription,one dosage per day,taken orally twice a day;both groups received one treatment course of one month,and three treatment courses were observed.The efficacy of Western medicine and TCM syndromes was observed,and the total symptom assessment scale of myeloproliferative neoplasms(MPN-10)scores,hematological indicators,coagulation function before and after treatment were compared.The safety indicators of the two groups were monitored.Results The control group and observation group lost 2 and 4 cases,respectively.The total effective rate of Western medicine in the observation group was 90.67%(68/75),while the control group was 67.57%(50/74),with statistical significance(P<0.01).The total effective rate of TCM syndromes in the observation group was 94.67%(71/75),while in the control group was 71.62%(53/74),with statistical significance(P<0.01).Compared with before treatment,the total score of MPN-10 in both groups significantly decreased(P<0.05);after treatment,the total score of MPN-10 in the observation group was lower than that in the control group(P<0.05).Compared with before treatment,both groups showed significant reductions in hemoglobin,white blood cell count,hematocrit and platelet count after treatment(P<0.05);after treatment,the above hematological indicators in the observation group were better than those in the control group(P<0.05).Compared with before treatment,the levels of D-dimer and fibrinogen

关 键 词：活血解毒方 热毒血瘀证 真性红细胞增多症 多中心 临床研究 

分 类 号：R259.5[医药卫生—中西医结合]