从脾论治慢性原发性免疫性血小板减少性症临床疗效观察

Clinic Observation on Idiopathic Throm-Bocytopenic Purpura by Treatment from Spleen

目的:观察从脾论治慢性原发性免疫性血小板减少性症(Chronic Idiopathic Throm-Bocytopenic Purpura,CITP)临床疗效,为CITP的治疗开拓思路。方法:符合入选病例标准的CITP门诊及住院患者60例,随机分为健脾益气摄血(A)组、健脾益气摄血配方颖粒联合泼尼松(B)组、泼尼松对照(C)组3组,分别给予健脾益气摄血配方颗粒、健脾益气摄血配方颖粒联合泼尼松、泼尼松治疗,各组疗程均为21 d。对3组患者治疗后中医证候积分、止血及血小板疗效分级评分,比较3组中医证候疗效、血小板与止血疗效。结果:1)中医证候疗效比较:A、B、C组3组总有效率分别为70.00%(14/20)、75%(15/20)及55%(11/20),3组比较差异有统计学意义(P<0.05);其中A、B组中医证候疗效优于C组,差异有统计学意义(P<0.05);2)血小板疗效比较:A、B、C组3组总有效率分别为50.00%(10/20)、75%(15/20)及45%(9/20),3组比较差异有统计学意义(P<0.05);其中B组血小板疗效优于其他组,差异具有统计学意义(P<0.05);3)止血疗效比较:A、B、C组3组总有效率分别为70.00%(14/20)、75%(15/20)及55%(11/20),3组比较差异有统计学意义(P<0.05);其中A、B组止血疗效优于C组,差异有统计学意义(P<0.05)。结论:健脾益气摄血法中药治疗慢性免疫性血小板减少症确有疗效,为从脾论治慢性原发性免疫性血小板减少性症提供理论依据。

Objective： To observe the therapeutic effect of treatment from the spleen on chronic idiopathic throm-bocytopenic purpura（ CITP）. Methods： Sixty patients with CITP were randomly assigned to three groups. Twenty patients were orally administered with Jianpi Yiqi Shexue Decoction（ JYSD） in the A treatment group,20 patients with JYSD and Prednisone in the B treatment group and the 20 with Prednisone in the control group. The therapeutic course was 21 days. Scores of the platelet effect hierarchical level and hemostasis effect hierarchical level were observed before and after treatment and TCM patterns clinical efficacy of the treatment was evaluated. Results： 1） TCM patterns： The effect rate of TCM patterns was 70% in the A treatment group,75%in the B treatment group and 55% in the C control group,respectively,showing significant difference between the three groups（ P〈0. 05）. The effect rate of A and B treatment groups were superior to that of the C control group（ P〈0. 05）. 2） Platelet effective rate： The platelet effective rate was 50% in the A treatment group,75% in the B treatment group and 45% in the C control group,respectively,showing significant difference between the three groups（ P〈0. 05）. The total effective rate showed significant difference between the three treatment group（ P〈0. 05）,The B treatment group of JYSD combined Prednisone were superior to the others; 3） Hemostasis effective rate was70% in the A treatment group,75% in the B treatment group and 55% in the C control group,respectively,showing significant difference between the three groups（ P〈0. 05） and the A and B treatment groups were superior to the C control group（ P〈0. 05）. Conclusion： 1） Treatment from the spleen on diopathic throm-bocytopenic purpura have a better efficacy and provides a new thinking for treating CITP.