芪黄汤治疗血小板减少症临床研究

Clinical Observation on Qihuang Decoction in Treatment of Thrombocytopenia

目的观察芪黄汤治疗血小板减少症的相关检验指标的变化及临床疗效。方法 52例血小板减少症患者随机分为两组,观察组给予芪黄汤内服,对照组采用"标准剂量强的松"方案治疗,分别于治疗后2d、7d、14d、28d测定外周血中血小板计数,观察患儿皮肤黏膜紫斑情况。监测统计两组患者血小板达到峰值时间、血小板恢复时间以及出血停止时间;检测治疗前和治疗28d后的外周血T-淋巴细胞亚群水平(淋巴细胞群、CD19^+、CD3^+、CD3^+CD4^-CD8^+、CD3^+CD4^+CD8^-、CD3^-CD16^+56^+);观察4周的临床疗效及半年后患者的复发情况。结果观察组总有效率明显高于对照组(<0.05);血小板恢复时间、达峰值时间以及出血停止时间均明显短于对照组(<0.05);两组血小板计数治疗后都有明显回升(<0.05),但观察组明显优于对照组(<0.05);两组治疗后的淋巴细胞群、CD3^+CD4^-CD8^+、CD19^+明显下降,CD3^+、CD3^+CD4^+CD8^-、CD3^-CD16^+56^+明显升高,观察组T-淋巴细胞亚群水平明显优于对照组(<0.05);两组治疗后6个月复发率比较,观察组明显低于对照组(<0.05)。结论芪黄汤能有效调节细胞免疫改善血小板功能,有良好的升高血小板数量和控制复发率的作用,长期预后效果良好。

Objective To observe the changes of related indicators and clinical curative effect of Qihuang decoction in treatment of thrombocytopenia. Methods 52 cases of patients with thrombocytopenia were randomly divided into observation group and control group. Observation group was treated with Qihuang decoction;control group received standard dose prednisone.The peak time of platelet,the time of platelet recovery and the time of bleeding cessation were monitored and analyzed. The level of T-lymphocyte subsets in peripheral blood before and after 28 d treatment was detected（lymphocyte cluster,CD19^＋,CD3^＋,CD3^＋CD4-CD8^＋,CD3^＋CD4^＋CD8-,CD3^-CD16^＋56^＋）;the clinical effect of 4 weeks and the recurrence after 6 months were observed. Results The total treatment efficiency of observation group was significantly higher than that of control group,and the difference was statistically significant（P〈0.05）,the platelet recovery time,peak time and bleeding cessation time were significantly shorter than those in control group（P〈0.05）. Both groups recovered significantly after platelet count（P〈0.05）,observation group was superior to control group（P〈0.05）. The lymphocyte group,CD19^＋,CD3^＋,CD3^＋CD4^-CD8^＋,CD3^＋CD4^＋CD8^-,CD3^-CD16^＋56^＋were significantly increased after treatment,and the T-lymphocyte subsets were significantly better in observation group than those in control group（P〈0.05）;the recurrence rate in observation group was significantly lower than that in control group（P〈0.05）. Conclusion Qihuang decoction can effectively regulate cellular immunity,improve platelet function with a good effect on increasing platelet count and controlling recurrence rate,and has a good long-term prognosis.