益髓生血颗粒治疗血红蛋白H病35例临床研究

Treatment of hemoglobin H disease with Yisui Shengxue Granules in 35 cases

目的探讨益髓生血颗粒治疗血红蛋白H病(HbH病)的临床疗效。方法采用自身对照方法,35例HbH(25例非缺失型HbH病患者和10例缺失型HbH病患者)病患者服用益髓生血颗粒,疗程3个月。动态检测患者治疗前后血液参数和治疗前后中医症候量化评分的变化,其中血液参数包括血红蛋白(Hb)浓度、红细胞(RBC)计数、网织红细胞(Ret)计数及血红蛋白H(HbH)的含量;中医症候量化评分选取肝肾阴虚、精血不足证的6个症候,包括面色萎黄、头晕目眩、食少纳呆、潮热盗汗、手足心热、爪甲色淡。结果 35例HbH病患者自服药第1个月起至3个月,血液参数Hb、RBC、Ret均明显提高(P<0.01)。25例非缺失型HbH病患者Hb、Ret水平明显提高(P<0.01)。10例缺失型HbH病患者Hb水平明显提高(P<0.01)。35例HbH病患者自服药第1个月起至3个月,面色萎黄、头晕目眩、手足心热、爪甲色淡的中医症候量化评分较疗前相比降低(P<0.01)。25例非缺失型HbH病患者,面色萎黄、手足心热、爪甲色淡的中医症候量化评分较疗前相比降低(P<0.01或P<0.05)。10例缺失型HbH病患者,面色萎黄,头晕目眩、潮热盗汗的中医症候量化评分较治疗前相比降低(P<0.01或P<0.05)。35例HbH病患者经3个月治疗后,总有效率为62.7%,其中缺失型HbH患者有效率为60%,非缺失型患者的有效率为64%,2种基因型患者的有效率比较,差异无统计意义。结论补肾益髓代表方益髓生血颗粒治疗HbH病疗效显著,提高HbH病患者Hb、RBC、Ret水平,同时能改善HbH病患者的中医症候。血液参数水平的提高和中医症候改善相一致。

Objective To investigate the curative effect of Yisui Shengxue Granules on hemoglobin H disease （HbH disease）.Methods By applying self-control study,35 patients with HbH disease （25 with non-defection HbH disease and 10 with defection HbH disease） were given Yisui Shengxue Granules for 3 m.The changes of blood parameters and quantitative scores of TCM syndromes were dynamically detected before and after treatment.The blood parameters included concentration of hemoglobin （Hb）,count of RBC,count of reticulocyte （Ret） and content of HbH,and 6 syndromes of liver-kidney yin deficiency syndrome and essence-blood deficiency syndrome were selected including sallow complexion,dizziness and dizzy vision,torpid intake and poor appetite,tidal fever and night sweating,heat in palms and soles,and pale nails.Results From the first month to the third month of treatment,the levels of Hb,RBC and Ret increased significantly （P 〈0.01） in 35 patients with HbH disease.The levels of Hb and Ret increased significantly （P 〈 0.01） in 25 patients with non-defection HbH disease,and level of Hb increased significantly （P 〈0.01） in 10 patients with defection HbH disease.From the first month to the third month of treatment,the quantitative scores of sallow complexion,dizziness and dizzy vision,heat in palms and soles,and pale nails decreased （P 〈 0.01） in 35 patients with HbH disease.The quantitative scores of sallow complexion,heat in palms and soles,and pale nails decreased （P 〈 0.01 or P 〈 0.05） in 25 patients with non-defection HbH disease.The quantitative scores of sallow complexion,dizziness and dizzy vision,and tidal fever and night sweating decreased （P 〈 0.01 or P 〈 0.05） in 10 patients with defection HbH disease.After treatment for 3 m,the total effective rate was 62.7% in 35 patients with HbH disease,60% in patients with defection HbH disease and 64% in patients with non-defection HbH disease.The comparison in effective rate between patients with 2 gene types had no statistical difference.Conclusion Yisui Shengxue Granules,a representative formula for tonifying kidney and marrow,has significant efficacy on HbH disease,which can improve the levels of Hb,RBC and Ret,and relieve TCM symptoms in the patients with HbH disease.The increase of blood parameters is consistent with the relief of TCM syndromes.