补肾填精方治疗非重型再生障碍性贫血临床观察

Clinical Observation on Non-severe Aplastic Anemia Treated with Bu Shen Tian Jing Prescription

目的:评估国医大师周仲瑛经验方——补肾填精方治疗非重型再生障碍性贫血(NSAA)的临床疗效。方法:选取江苏省中医院血液科收治的病程超过1年、环孢素撤减困难的NSAA患者40例,给予口服补肾填精方治疗,12周为1个疗程,共观察至少3个疗程。观察指标包括治疗前后患者血常规、环孢素撤减率、肝肾功能及健康相关生活质量的变化。结果:临床总体有效率为82.5%(33/40例),其中治愈11例、缓解15例、明显进步7例、无效7例;总环孢素撤减率52.5%(21/40例)。经中西医结合治疗后,患者外周血中性粒细胞、血红蛋白和血小板计数值较治疗前明显提高(P<0.05)[(1.93±1.32)×10^(9)/L vs(2.28±0.98)×10^(9)/L,(90.63±21.95)g/L vs(110.85±19.34)g/L,(44.5±41.04)×10^(9)/L vs(71.95±50.39)×10^(9)/L];SF-36量表中7个维度分值显著提高(P<0.05)。无患者因不良反应中止治疗或减量。结论:补肾填精方治疗NSAA效果确切,安全性高,有助于环孢素撤减和改善患者生活质量。今后应开展随机、对照试验,并扩大样本量,进一步验证该方效果。

Objective:To evaluate the clinical efficacy and safety of Bu Shen Tian Jing Recipe which is experience of Zhou Zhongying in the treatment of non-severe aplastic anemia(NSAA).Methods:In the Department of Hematology of Jiangsu Provincial Hospital of Traditional Chinese Medicine,40 patients with NSAA for more than 1 year who had difficulty in withdrawal of cyclosporine were enrolled in this study.Take 12 weeks as a course of treatment,and observe a total of 3 courses.The observation indicators included changes in blood routine,cyclosporine withdrawal rate,liver and kidney function,and quality of life scores before and after treatment.Results:The total effective rate of NSAA patients was 82.5%(33/40)after treatment with Bu Shen Tian Jing Prescription.Among them,11 cases were totally cured,15 cases were partial remission,7 cases were apparently improved,and 7 cases were completely ineffective.The total cyclosporine withdrawal rate was 54.5%(18/33).In this cohort,the absolute values of neutrophil count(ANC),serum hemoglobin(Hb)and platelet(PLT)count after treatment were significantly higher than those before(P<0.05)(1.93±1.32)10^(9)/L vs(2.28±0.98)10^(9)/L;(90.63±21.95)g/L vs(110.85±19.34)g/L;(44.5±41.04)10^(9)/L vs(71.95±50.39)10^(9)/L].The scores of 7 dimensions in the SF-36 scale were significantly improved(P<0.05).No patients reported severe adverse reactions.Conclusion:Bu Shen Tian Jing Prescription in the treatment of NSAA is effective and safe,which helps cyclosporine withdrawal and improves patients’quality of life.Randomized controlled trial could be conducted to verify the effect of this recipe in future.