益气健脾摄血法配合西药治疗成人免疫血小板减少性紫癜对IL-2、IL-4的影响

Clinical Effect of the Method of Reinforcing Qi,Invigorating Spleen and Taking Blood Combined with Western Medicine on the Treatment of Adult Patients with Immune Thrombocytopenic Purpura

目的观察益气健脾摄血中药配合西药探讨免疫性血小板减少性紫癜(ITP)患者治疗前后血清白介素2(IL-2)、白介素4(IL-4)变化及临床意义。方法将40例辨证为气不摄血证的ITP患者随机分为两组:对照组及治疗组。对照组予西药治疗,治疗组在对照组基础上加用中药治疗,总疗程为3个月。应用酶联免疫吸附试验(ELISA)测定所有ITP患者治疗前、后血清中IL-2、IL-4水平变化,观察临床总疗效、中医证候疗效及血小板变化。结果 2组治疗后IL-2升高,IL-4下降,2组内治疗前后IL-2、IL-4比较,差异有统计学意义(P<0.01),治疗组IL-2升高及IL-4下降更明显,与对照组相比,差异有统计学意义(P<0.05);总有效率对照组75%,治疗组91%,2组总有效率比较,差异具统计学意义(P<0.05);中医证候积分总有效率对照组80%,治疗组95%,2组比较,差异有统计学意义(P<0.05);2组治疗后血小板变化,治疗组血小板升高更明显,2组比较差异有统计学意义(P<0.05)。结论 IL-2和IL-4可能参与了ITP自身免疫紊乱的过程,其水平的高低影响ITP的预后,中西医结合对IL-2水平的升高及IL-4水平下降更明显,疗效更优。

Objective terleukin - 4 （ IL - 4 ） of spleen and taking blood co failing ： To observe the changes and clinical significance serum interleukin - 2 （ IL - 2 ） and in- immune thrombocytopenic purpura patients by the method of reinforcing qi, invigorating mbined with western medicine before and after the treatment. Methods： 40 patients with qi to control blood syndrome were randomly divided into a control group and a treatment group. The control group was treated with western medicine while the treatment group was given with TCM treatment besides conventional western medicine. Three months was a course of treatment. The serum IL - 2 and IL - 4 changes of the patients were measured by ELISA before and after the treatment and their total clinical effect, TCM syndrome and platelet change were observed. Results ： After the treatment, their IL - 2 level increased and their IL - 4 decreased. The comparison of the IL- 2 and IL-4 of the two groups showed the difference was statistically significant（ P 〈 0.01 ）. The IL- 2 increase and IL -4 decrease of the treatment group were more significant. When compared with the control group, the difference was statistically significant（P 〈0.05 ）. The total effectiveness of the treatment group was 91% while that of the control group was 75%. The total effective rate comparison of the two groups showed a statistically significant differ- ence（P 〈0.05）. For the total effective rate of TCM syndrome score, the treatment group was 90% and the control group was 80%, The comparison of the two groups showed the difference was statistically significant（P 〈0.05）. The platelet changes of the two groups after the treatment was that the treatment group obviously increased. The comparison of the two groups showed the difference was statistically significant （ P 〈 0.05 ）. Conclusion ： The IL - 2 and IL - 4 may be involved in the process of ITP autoimmune disorders and their level may affect the prognosis of ITP. The integration of TCM and western medicine has an obvious and better effect on the increase of IL-2 and the decrease of IL-4.