探索扶正解毒方对免疫性血小板减少症儿童患者血小板功能的影响

Explore the effect of Fuzheng Jiedu decoction on platelet function in children with immune throm-bocytopenia

目的观察扶正解毒方治疗儿童原发免疫性血小板减少症(immune thrombocytopenia,ITP)的临床疗效及其对血小板功能的影响。方法将30例符合标准的持续性、慢性ITP患儿随机分为治疗组和对照组,每组15例,治疗组予扶正解毒方联合小剂量醋酸泼尼松治疗;对照组予中药模拟剂联合小剂量醋酸泼尼松治疗;疗程3个月,比较两组的有效率、血小板计数、血栓弹力图各参数及中医证候积分、出血评分量表等。结果治疗组和对照组各脱落1例,每组共完成14例。治疗3个月时治疗组的总有效率为64.3%,包括完全反应率42.9%、有效率21.4%,高于对照组,有显著统计学差异(P<0.01);比较两组血栓弹力图中R、K、Angle、MA、LY30、CI数值,两组差异无统计学意义(P>0.05);重点对MA值进行自身前后比较,治疗组与对照组自身前后比较MA值差异均无统计学意义(P>0.05);比较治疗3个月后两组主证、次证的积分变化,患儿紫斑出血、神疲乏力、气短、口干、便溏、自汗症状积分均低于对照组,差异均有统计学意义(P<0.05);比较治疗后两组出血评分量表,治疗组总改善率85.7%,明显高于对照组42.9%,差异有统计学意义(P<0.05);治疗期间两组安全性指标无明显异常。结论扶正解毒方治疗儿童原发免疫性血小板减少症有效,且安全性高。

Objective To observe the clinical effect of Fuzheng Jiedu decoction on immune throm-bocytopenia in children and its effect on platelet function. Methods 30 patients with durative and chronic immune thrombocytopenia （ITP） were randomly divided into treatment group and control group, 15 cases in each group. The treatment group was treated with Fuzheng Jiedu decoction combined with low-dose prednisone therapy; the control group was treated with simulant traditional Chinese medicine combined with low dose prednisone treatment; the course of treatment was 3 months, effective rate, platelet count, the pa-rameters of thrombelastogram, TCM score, and scale of bleeding score was compared. Results 1 case fell off in treatment group and control group respectively, each group completed a total of 14 cases. 3 months after treatment, the total effective rate was 64. 3% in treatment group, including complete response rate was 42. 9% , efficiency was 21. 4% , the results were higher than those of the control group, with significant difference （P〈0. 01）; there was no statistical difference in R, K, Angle, MA, LY30 and CI between the two groups （P〉0. 05）. Focus on the comparison of MA value before and after, there was not statistically significant in the treatment group and the control group before and after the comparison （P〉0. 05）. The integral of the main symptoms and secondary syndromes, symptom scores of patient with purple bleeding, lassitude, shortness of breath, dry mouth, loose stools, sweating in the treatment group were lower than those of control group, the differences were statistically significant （ P 〈 0. 05） after 3 months of treatment; After treatment, the total improvement rate of bleeding score scale in the treatment group was 85. 7% , which was significantly higher than that was 42. 9% in the control group, the difference was statistically significant （P〈0. 05）; there was non apparent abnormality of security index during the treatment in the two groups. Conclusion Fuzheng Jiedu decoction is effective and safe in the treatment of primary immune thrombocytopenia in children.