摘要
目的观察薏苡竹叶散辅助治疗湿热蕴毒型免疫性血小板减少性紫癜(ITP)的临床疗效。方法将98例湿热蕴毒型ITP患者按照随机数字表法分为2组,对照组49例(后退出2例)予糖皮质激素治疗,观察组49例(后退出2例)在对照组基础上予薏苡竹叶散辅助治疗,2组均治疗6周。比较2组治疗前后中医证候改善情况、血小板情况(血小板压积、血小板计数、血小板平均体积)、血小板相关免疫球蛋白A(PAIgA)、PAIgG、PAIgM、血清炎症因子[白细胞介素2(IL-2)、IL-4、IL-17]及T淋巴细胞亚群水平(CD3^(+)、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+)),并统计疗效及不良反应情况。结果观察组总有效率93.62%(44/47),对照组总有效率78.72%(37/47),观察组疗效优于对照组(P<0.05)。2组治疗后各项中医证候均较本组治疗前明显改善(P<0.05),且观察组治疗后各项中医证候改善程度均优于对照组(P<0.05)。2组治疗后血小板压积、血小板计数、血小板平均体积均较本组治疗前升高(P<0.05),且观察组治疗后均高于对照组(P<0.05)。2组治疗后PAIgA、PAIgG、PAIgM水平均较本组治疗前降低(P<0.05),且观察组治疗后均低于对照组(P<0.05)。2组治疗后血清IL-2、IL-4、IL-17水平均较本组治疗前降低(P<0.05),且观察组治疗后均低于对照组(P<0.05)。2组治疗后CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)细胞比值均较本组治疗前升高(P<0.05),CD8^(+)细胞均降低(P<0.05),且观察组治疗后CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)细胞比值均高于对照组(P<0.05),CD8^(+)细胞低于对照组(P<0.05)。观察组不良反应发生率低于对照组(P<0.05)。结论薏苡竹叶散辅助治疗湿热蕴毒型ITP临床疗效显著,可改善中医证候,提高血小板水平,并降低血小板相关抗体及炎症因子水平,提高机体免疫功能。
Objective To observe the clinical efficacy of Yiyi Zhuye Powder for immune thrombocytopenic purpura(ITP)of damp-heat toxicity type.Methods Ninety-eight patients with ITP of damp-heat toxicity type were randomly assigned into observation group(n=49,2 cases dropped off)and control group(n=49,2 cases dropped off).All patients were managed by routine hormone therapy,and those in observation group were additionally treated with Yiyi Zhuye Powder.Treated for 6 weeks,the aim was to compare improvement of traditional Chinese medicine(TCM)symptoms,platelet hematocrit,platelet count,mean platelet volume,platelet-associated immunoglobulin A(PAIgA),PAIgG,PAIgM,interleukin-2(IL-2),IL-4,IL-17,and T lymphocyte subsets(CD3^(+),CD4^(+),CD8^(+),CD4^(+)/CD8^(+))between groups before and after treatment.The efficacy and adverse reactions were assessed.Results The overall effective rate in the observation group was significantly higher than that in the control group(93.62%[44/47]vs 78.72%[37/47],P<0.05).After treatment,TCM symptoms in the both groups were significantly improved compared with before treatment(P<0.05),the improvement of which in the observation group were significantly better than the control group(P<0.05).The platelet hematocrit,platelet count,and average platelet volume in the both groups after treatment were significantly increased compared with before treatment(P<0.05),the increases in the observation group were more common than the control group(P<0.05).After treatment,PAIgA,PAIgG,and PAIgM levels in the both groups were significantly decreased(P<0.05),which in the observation group were significantly lower than those in the control group(P<0.05).IL-2,IL-4,and IL-17 levels in the both groups were significantly decreased(P<0.05),the decreases in the observation group were more prevalent compared with the control group(P<0.05).After treatment,significantly increased CD3^(+),CD4^(+)and CD4^(+)/CD8^(+),and decreased CD8^(+)were detected in the both groups(all P<0.05),and the observation group was superior to the control group for CD3^(+),CD4^(+),CD4^(+)/CD8^(+),CD8^(+)(all P<0.05).The incidence of adverse reactions in the observation group was significantly lower than that in the control group(P<0.05).Conclusion Yiyi Zhuye Powder has significant clinical efficacy in patients with ITP of damp-heat toxicity type,which can improve TCM symptoms,increase platelet levels,reduce platelet-related antibodies and inflammatory factor levels,and enhance the body's immune function.
作者
汪莉
周正国
李铁
WANG Li;ZHOU Zhengguo;LI Tie(The First Clinical Medical College,Liaoning University of Traditional Chinese Medicine,Shenyang,Liaoning 110000;Department of Traditional Chinese Medicine,the Second People's Hospital of Dalian,Dalian,Liaoning 116011)
出处
《河北中医》
2025年第11期1831-1835,1839,共6页
Hebei Journal of Traditional Chinese Medicine
基金
全国名老中医药专家传承工作室建设项目(国中医药人教函〔2019〕41号)
2023年度大连市生命健康领域指导计划项目(编号:2023SMJK002)
辽宁省“兴辽英才计划”医学名家资助项目(编号:XLYC2412054)。
关键词
免疫性血小板减少性紫癜
中药疗法
血小板
Immune thrombocytopenic purpura
Traditional Chinese medicine therapy
Platelet
