益气养血方剂在免疫性血小板减少症伴发血栓患者治疗中的作用

Role of Using Yiqi Yangxue Prescription in the Treatment of Patients with Immune Thrombocytopenia and Thrombus

目的:观察益气养血方剂联合西药治疗原发免疫性血小板减少症伴发血栓的临床疗效及其对机体血小板计数、D-二聚体、出血情况、不良反应的影响。方法:将2008年5月~2018年5月诊治的90例免疫性血小板减少症伴发血栓患者随机分为两组,治疗组及对照组各45例。对照组采用醋酸泼尼松片治疗,治疗组在对照组基础上联合益气养血方剂。连续稳定治疗3个月后,对比两组患者的临床疗效、血小板计数、D-二聚体、出血程度及不良反应发生情况。结果:治疗组总有效率86.7%,优于对照组,差异具有统计学意义(P<0.05);两组治疗后PLT计数较治疗前均有上升(均P<0.05),且治疗组明显优于对照组(P<0.05);两组治疗后D-二聚体较治疗前均有下降(均P<0.05);治疗后,治疗组的出血情况较治疗前明显改善,且优于对照组(P<0.05);对照组治疗前后出血情况差异无统计学意义;治疗组不良反应的发生率明显低于对照组。结论:采用益气养血方剂联合西药治疗原发免疫性血小板减少症伴发血栓患者,能有效升高PLT计数,改善出血症状,降低出血风险,抵抗激素副反应,提高生存质量,临床值得推广。

Objective:To observe the clinical efficacy,platelet count,D-dimer,hemorrhage and adverse reactions of primary immune thronibocytopenia and thrombus treated by the Yiqi Yangxue Prescription and western medicine.Methods:90patienls who entered this hospital from May 2008to May 2018,were randomly divided into treatment group and controlled group,with each group of 45cases.The controlled group adopted the traditional treatment of western medicine.The controlled group was treated with Prednisone Acetate Tablets,and the treatment group adopted Yiqi Yangxue Prescription on the basis of the controlled group.After 3months of treatment,the clinical efficacy,platelet count,D-dimer,bleeding degree and adverse reactions of the two groups were compared.Results:The total effective rate in the treatment group was 86.7%,better than that in the controlled group.The difference between the two groups was statistically significant(P<0.05).After treatment,the PLT counts of the peripheral blood in the two groups increased compared to the pre-treatment(P<0.05),and the treatment group were significantly higher than the controlled group(PvO.05).D-dimer decreased after treatment in both groups compared with that before treatment(P<0.05).After treatment,the bleeding in the treatment group was significantly improved compared with the pre-treatment,and was superior to the controlled group(P<0.05).There was no significant difference in bleeding before and after treatment in the controlled group(P>0.05).The incidence of adverse reactions in the treatment group was significantly less than that in the controlled group.Conclusion:Using Yiqi Yangxue Prescription and western medicine in treating patients with immune thrombocytopenia and thrombus,which was worthy of clinical promotion,can effectively increase the PLT counts,improve symptoms of bleeding,reduce the risk of bleeding in thrombolytic treatment,resist honnone side effects and improve the quality of life.