急性髓劳病分期论治诊断依据初探

Approach of staging evidences of acute aplastic anemia

目的:探求急性髓劳病(即急性再生障碍性贫血)的分期诊断依据。方法:对本科1996年3月-2008年12月收住的104例急性髓劳病患者病历资料做了回顾性统计分析,探讨各期中医四诊摘要、辨型诊断与西医血常规、骨髓常规相应指标间的相关性。结果:"凉-温-热"三期间,白细胞计数(WBC)、绝对中性粒细胞数(ANC)、网织红细胞百分比(Ret%)、骨髓红细胞比、淋巴比、巨核细胞数均存在着显著性差异(P<0.05或P<0.01);血小板计数(PLT)与血红蛋白量(Hb)仅在"热"期明显上升(P<0.01);WBC、ANC、Ret%、骨髓红系及淋巴系比的95%可信区间不存在交叉。结论:西医量化诊断指标能较好指导急性髓劳病中医"凉-温-热"分期,其中以WBC、ANC、Ret%、骨髓红系及淋巴系比具有较好的参考意义,PLT、Hb则对疾病预后具有较好指示性。

Objective：To explore the staging evidences of acute suilao （acute aplastic anemia）. Methods：The case history of 104 definited patients between 1996-03-01 and 2008-12-31 were reviewed. The diagnostic evidence of both TCM and Western medicine （including blood and marrow routine） were recorded one by one,and the correlations between them were analyzed. Results：Significant differences were observed among the ＇cool＇,＇warm＇,and ＇hot＇stages in white blood cell count （WBC）,absolute neutrophil count （ANC）,reticulocyte percentage of blood routine test （Ret%） and erythrocyte series ratio,lymphocyte series ratio and megakaryocyte count of bone marrow routine test （P0.05 or P0.01） which were taking a favorable turn. The increase of platelet and hemoglobin were slow,which became noted in ＇hot＇ stage only （P0.01）. No intersections of 95% confi dence interval were found among different stages on WBC,ANC,Ret%,erythrocyte and lymphocyte series ratio. Conclusion：The diagnostic criteria of Western medicine were helpful to the staging of acute suilao of TCM. Among which,WBC,ANC,Ret%,erythrocyte and lymphocyte series ratio of marrow had a better signifi cance in staging,while the amount of platelet and hemoglobin may have a good demonstration to the prognosis.