健脾益气摄血颗粒对脾气虚型慢性免疫性血小板减少症淋巴细胞亚群的影响

Effect of Jianpi Yiqi Shexue Granule on the Lymphocyte Subpopulation of Chronic Immune Thrombocytopenia Patients with Spleen Deficiency Syndrome

目的探讨健脾益气摄血颗粒对脾气虚型慢性免疫性血小板减少症淋巴细胞亚群的影响。方法符合入选病例标准的慢性免疫性血小板减少症(CITP)门诊及住院患者40例,随机分为健脾益气摄血联合强的松治疗组、单用强的松为对照组,分别给予健脾益气摄血配方颗粒联合强的松及单用强的松治疗,各组疗程均为21 d,比较2组患者治疗前后其外周血CD_(19)^+细胞表达及T淋巴细胞亚群变化。结果 (1)中医证候疗效比较:治疗组及对照组总有效率分别为75%(15/20)、40%(8/20),二组比较差异有统计学意义(P<0.05);其中治疗组中医证候疗效优于对照组,差异有统计学意义(P<0.05);(2)CD_(19)^+B细胞表达比较:对照组患者CD_(19)^+CD_(27)^+及C_(19)^+CD_(27)-B细胞表达治疗前后比较差异无统计学意义(P>0.05),治疗组治疗前后及与对照组治疗后比较差异有统计学意义(P<0.05)。其中治疗组CD_(19)^+细胞比例低于对照组;(3)T细胞亚群变化比较:治疗组患者血清CD_4^+百分率较治疗前以及对照组均显著降低,而CD_8^+百分率则升高,CD_4^+/CD_8^+比例显著减小(P<0.05)。结论健脾益气摄血颗粒能提高脾气虚型慢性免疫性血小板减少症中医症候临床疗效,对体液免疫及细胞免疫具有调节作用。

Objective To investigate the expression of lymphocyte subsets to Jianpi Yiqi Shexue Granule（JYSG） on chronic immune thrombocytopenia（CITP） patients with spleen deficiency syndrome. Methods The 40 CITP patients with spleen deficiency syndrom were randomly assigned to the treatment group treated with JYSG ^＋prednisone and control group treated with prednision, the course was for 20 days. The expression of CD19^＋and T-lymphocyte subsets of the two groups were observed before and after treatment. Results（1） TCM syndromes： the effective rate of TCM syndromes in the treatment group and control group was 75%（15/20） and 40%（8/20）, respectively, with significant diffiences between the two groups（P〈0.05）. The treatment group were superior to the control group, with statistically significance（P〉 0.05）.（2） The expression of CD19^＋cell： the expression of CD19^＋CD27^in the observation group has no obvious significance（P 〉0.05）,the differences between the treatment group and control group before and after treatment were significant（P〈0.05）. And the CD19^＋cell ratio of the treatment group was lower than the control group.（3） The changes of T-lymphocyte subsets： the CD4^＋rate in treatment group after treatment was obviously lower than that in the control group（P〈0.05）, the precentage of CD_8~＋increased, while CD4^＋/CD8^＋ratio reduced. Conclulation JYSG can improve the symptoms of CITP patients with spleen deficiency, and show the regulating effect on cellular immunity and humoral immunity function.