生血灵治疗特发性血小板减少性紫癜的临床研究

Clinical study on idiopathic thrombocytopenic purpura treated with Shengxueling Granule

目的 :观察健脾补肾、泻火凉血中药生血灵治疗特发性血小板减少性紫癜 (idiopathicthrombocytopenicpurpura ,ITP)的临床疗效 ,探索其作用机制。方法 :将 86例ITP患者随机分为两组 :治疗组 5 6例用生血灵治疗 ,对照组 30例用强的松治疗 ,观察临床疗效和治疗前后血小板计数 (bloodplateletcount,BPC)、血小板相关抗体 (plateletassociatedimmunoglobulin ,PAIg)、自然杀伤细胞活性 (naturalkillercellsactivity ,NKCA)、IL 4、T淋巴细胞亚群、骨髓象等指标的变化。 结果 :治疗 3个月后 ,治疗组总有效率为 85 .71% ,对照组为 83.33% ,两组比较无显著差异 (P >0 .0 5 ) ;治疗 6个月后 ,治疗组总有效率为91.0 7% ,对照组为 5 3.33% ,治疗组明显高于对照组 (P <0 .0 1) ,且无不良反应。治疗组大多数病人治疗后在临床出血减轻或消失、全身症状改善的同时 ,BPC明显上升 ,增高的PAIg恢复正常或大幅度降低 ,NKCA明显升高 ,IL 4明显减少 ,T淋巴细胞亚群比例趋向正常 ,骨髓象中原、幼巨核细胞和颗粒型巨核细胞明显减少 ,产板型巨核细胞显著增加 ,部分病人的束臂试验由阳性转为阴性。结论 :生血灵治疗ITP疗效良好 ,安全无毒 ,能调节机体的免疫功能 ,抑制血小板抗体 ,减少血小板的破坏 ;

Objective: To observe the clinical effect of Shengxueling Granule (SXLG) in treating idiopathic thrombocytopenic purpura (ITP), and to study its possible mechanism. Methods: Eighty-six cases of ITP were divided into two groups randomly. Fifty-six cases in the treatment group were treated with SXLG, a traditional Chinese medicine, and 30 cases administered with Western medicine (prednisone) were taken as control. Patients in each group took drugs for three months and were under follow-up observation. Results: In SXLG-treated group, the total effective rate in 3 months was 85.71%, similar to 83.33% in prednisone-treated group (P>0.05), while the total effective rate in 6 months in the SXLG-treated group was 91.07%, higher than 53.33% of the prednisone-treated group (P<0.01), and no obvious side-effects were observed. The patients’ bleeding was alleviated or stopped, and their general condition was improved. And the blood platelet count (BPC) was increased, the platelet associated immunoglobulin (PAIg) and interleukin-4 (IL-4) were markedly dropped, the level of natural killer cells activity (NKCA) increased, and the rate of T lymphocyte subsets gradually returned to normal level. Megakaryocytes tended toward maturation on bone marrow smear after SXLG treatment. All differences above were statistically significant. Conclusion: SXLG is an effective and safe medicine for ITP. It can regulate the cellular immunity, inhibit the platelet antibody to reduce the destruction of the platelet and to increase the number of platelet, promote the differentiation and maturation of megakaryocyte, facilitate the production and release of platelet, lower the fragility of capillary, and prevent the hemorrhagic tendency.