生血灵联合小剂量激素治疗激素抵抗型免疫性血小板减少症临床观察

Combination of “Shengxueling”and low dose hormone for steroid-resistant immune thrombocytopenia

目的观察生血灵联合小剂量激素治疗激素抵抗型免疫性血小板减少症的临床疗效及其对血小板生成素(TPO)水平的影响。方法将60例患者分为治疗组(45例)和对照组(15例),治疗组予生血灵联合小剂量泼尼松,对照组单用小剂量泼尼松。两组疗程均为6个月,观察临床疗效及外周血血小板计数、血浆TPO水平变化情况。结果治疗组、对照组总有效率分别为75.6%、33.3%,治疗组临床疗效优于对照组(P<0.05)。两组治疗后血小板计数均明显增加(P<0.05),治疗组增加幅度大于对照组(P<0.05)。与正常组比较,治疗组、对照组治疗前血浆TPO水平均明显升高(P<0.05);治疗后治疗组TPO水平明显降低(P<0.05),对照组无明显变化(P>0.05);治疗组降低TPO水平的作用优于对照组(P<0.05)。结论生血灵联合小剂量激素治疗激素抵抗型免疫性血小板减少症,疗效明显优于单纯小剂量激素;激素抵抗型患者血浆TPO水平高于正常人;生血灵联合小剂量激素治疗激素抵抗型免疫性血小板减少症的作用机制可能与调控TPO水平有关。

Objective To observe the clinical efficacy of ＂Shengxueling＂ and low dose hormone for steroid-resistant immune thrombocytopenia （ITP） and to explore its effect on thrombopoietin （ TPO ）. Methods Sixty cases were randomized into two groups ： treatment group in which 45 cases were treated by ＂Shengxueling＂ and low dose metacortandracin, and control group in which 15 cases were treated by low dose metacortandracin, with the course of 6 months. The clinical efficacy., peripheric platelet count and TPO were observed. Results The total effective rate was 75.6% in the treatment group and 33.3% in the control group, with a difference between the two groups （P 〈 0.05 ）. Compared with normal group, the TPO level in the treatment group and control group was increased markedly （ P 〈 0.05 ） ; after treatment, the TPO level was reduced in the treatment group （ P 〈 0, 05） ; no significant difference was found in the control group （P 〉 0.05 ） ; reduction of TPO level in the treatment group was superior to that of the controls （ P 〈 0.05 ）. Conclusion Combined ＂ Shengxuding＂ and low dose metacortandracin has positive effect on steroid-resistant immune thrombocytopenia, which is better than using metacortandracin only. TPO level is higher in steroidresistant patients than that in the normal people. The mechanism of ＂Shengxueling＂ and low dose metacortandracin on immune thrombocytopenia may be association with the regulation of TPO level.