枸杞二黄汤加味联合小剂量美罗华对利奈唑胺药物性血小板减少症相关指标的影响

The effects of Gouqierhuang decoction combined with small dose of rituximab on the related indexes in the patients with drug-induced thrombocytopenia

目的探讨枸杞二黄汤加味联合小剂量美罗华治疗利奈唑胺药物性血小板减少症的相关指标的影响。方法选取104例因利奈唑胺导致血小板减少症的患者,采用随机数字表法分为对照组及研究组,每组52例。对照组在常规治疗的基础上给予小剂量美罗华治疗,研究组在对照组的基础上给予枸杞二黄汤加味联合小剂量美罗华治疗,同时选择健康者52例作为健康组,分别对研究组、对照组及健康组患者进行治疗前后血清白介素-33(IL-33)、肿瘤坏死因子-α(TNF-α)、干扰素-γ(IFN-γ)和血小板、白细胞、血红蛋白水平、肝功能及肾功能检测,观察其变化情况。结果治疗前研究组及对照组患者血清IL-33、TNF-α和IFN-γ水平明显高于健康组,血小板、血红蛋白和白细胞水平明显低于健康组,差异有统计学意义(P <0. 05),且对照组和治疗组患者上述指标相比较差异无统计学意义(P>0. 05);治疗后对照组和治疗组患者血清IL-33、TNF-α和IFN-γ水平均明显下降,血小板计数明显上升,且研究组上述指标水平明显低于对照组(P <0. 05);治疗后对照组和治疗组患者的白细胞、血红蛋白以及肝、肾功能水平同治疗前比较,差异无统计学意义(P> 0. 05)。结论枸杞二黄汤加味联合小剂量美华罗治疗利奈唑胺药物性血小板减少症可有效降低患者的血清IL-33、TNF-α及IFN-γ水平,提高患者的血小板计数,但对于白细胞及血红蛋白指数的改善情况不明显,值得临床进一步推广探究。

Objective To investigate the effects of Gouqierhuang decoction combined with small dose of rituximab on the related indexes in the patients with drug-induced thrombocytopenia.Methods A total of 104 patients with drug-induced thrombocytopenia.Who were treated in our hospital were enrolled in the study.According to random digital table method,these patients were divided into control group(n=52)and research group(n=52).The patients in contrl group,on the basis of routine therapy,were treated by small dose of mabthera,however,the patients in research group,on the basis of control group,were treated by Gouqierhuang decoction,at the same time,the other 52 healthy subjects were enrolled as health control group.The serum levels of IL-33 TNF-alpha(TNF-α)and IFN-gamma(IFN-γ),platelet,WBC,hemoglobin,liver function before and after treatment were observed and compared among the three groups.Results Before treatment the serum levels of IL-33,TNF-αand IFN-γin research group and control group were significantly higher than those in healthy control group,however,the levels of platelet,WBC,hemoglobin were significantly lower than those in healthy control group(P<0.05),moreover,there were no significant differences in above indexes between research group and control group(P >0.05).After treatment the serum levels of IL-33,TNF-αand IFN-γin research group and control group were significantly decreased,and platelet count was significantly increased,moreover,the levels of these indexes in research group were significantly lower than those in control group(P<0.05).In addition after treatment there were no snificant differences in thelevelsof WBC,hemoglobin,liver function,kidney function between control group and research group(P >0.05).Conclusion Gouqierhuang decoction combined with small dose of rituximab in treatment of drug-induced thrombocytopenia can effectively decrease the serum levels of IL-33,TNF-αand IFN-γ,and increase blood platelet count,nut,which can not improve WBC and hemoglobin obviously,which needs to be reearched further.