二陈桂枝汤治疗特发性血小板减少性紫癜寒湿困脾型临床观察

Clinical observation of Erchen-guizhi decoction on the treatment of idiopathic thrombocytopenic purpura with cold-dampness disturbing spleen type

目的观察二陈桂枝汤治疗特发性血小板减少性紫癜(ITP)寒湿困脾型临床疗效。方法将80例证属寒湿困脾型的ITP患者随机分为2组,对照组40例应用单纯西药治疗,治疗组40例在对照组治疗基础上应用二陈桂枝汤治疗。比较2组疗效,观察2组治疗前后主要中医症状评分,并观察治疗前后患者血小板计数(PLT)、白细胞介素2(IL-2)及IL-4。结果 2组治疗后主要中医症状评分均较本组治疗前降低(P<0.05),且治疗组治疗后较对照组降低更明显(P<0.05)。2组治疗后PLT及IL-2均较本组治疗前升高(P<0.05),IL-4降低(P<0.05);且治疗组治疗后PLT及IL-2升高、IL-4降低较对照组更明显(P<0.05)。总有效率治疗组80.00%,对照组52.50%,2组总有效率比较差异有统计学意义(P<0.05),治疗组疗效优于对照组。结论二陈桂枝汤可显著提高寒湿困脾型ITP患者临床疗效,改善主要中医症状,升高PLT及IL-2,降低IL-4,并降低不良反应发生率。

Objective To observe the clinical effects of Erchen - guizhi decoction on the treatment of idiopathic thrombocytopenic purpura（ITP）with cold - dampness disturbing spleen type. Methods 80 ITP patients with cold - dampness disturbing spleen type were randomly divided into two groups. The control group（n = 40）received western medicine only,and the treatment group received Erchen - guizhi decoction on the basis of control group treatment. The curative effect was evaluated between two groups. The main symptom score of traditional Chinese medicine（TCM）,the counts of PT,interleukin - 2（IL - 2）and IL - 4 before and after treatment were observed in two groups. Results The main symptom score of TCM after treatment were decreased in two groups（P 〈0. 05）,and the decrease in treatment group was more obvious（P 〈 0. 05）. The PLT and IL - 2 after treatment were increased in two groups,the IL - 4 was decreased（P 〈 0. 05）. The improvements of PLT,IL - 2 and IL - 4 in treatment group were more significant than control group（P 〈 0. 05）. The total effective rate in treatment and control group was 80. 00% and 52. 50% ,respectively. The total curative effect in treatment group was superior to that in control group（P 〈 0. 05）. Conclusion Erchen - guizhi decoction can significantly improve the clinical effects on the treatment of ITP with cold - dampness disturbing spleen type,improve the main symptoms of TCM,increase PLT and IL - 2,and decrease IL - 4,with fewer adverse reactions.