益气养阴止血方治疗儿童慢性原发免疫性血小板减少症临床观察

Clinical Observation of Using Yiqi Yangyin Zhixue Decoction in the Treatment of Children with Chronic Primary Immune Thrombocytopenia

目的:评估益气养阴止血方治疗儿童慢性原发免疫性血小板减少症(cITP)的临床疗效。方法:纳入湖南中医药大学第一附属医院导师蒋文明教授门诊治疗的证属气阴两虚型cITP患儿25例,作为治疗组,口服益气养阴止血方剂治疗12周,观察记录入组患儿治疗前后血小板计数、中医证候积分、外周血T淋巴细胞亚群(CD_(3)^(+)、CD_(4)^(+)、CD_(8)^(+)、CD_(4)^(+)/CD_(8)^(+))变化情况。结果:(1)西医临床总缓解率为76%,治疗组治疗前、治疗后比较血小板计数呈上升趋势,出血情况明显改善,结果有显著性差异(P<0.05);(2)中医证候改善总有效率84%,治疗组治疗前与治疗后比较有显著性差异(P<0.05);(3)治疗组治疗前、治疗后患儿外周血中表达的T细胞分别与正常对照组比较,结果均无显著性差异(P<0.05)。结论:益气养阴止血方能有效改善"气阴两虚证"cITP患儿的出血症状,提高外周血小板计数,可有效改善cITP患儿中医证候。

Objective:To evaluate the clinical effect of using Yiqi Yangyin Zhixue Decoction in the treatment of chronic primary immune thrombocytopenia(ctitp)in children for.Methods:25 cases of Qi-Yin deficiency type cITP were included in the clinic treatment of Professor JIANG Wenming,the tutor of the First Affiliated Hospital of Hunan University of Traditional Chinese Medicine.As the treatment group,the patients were treated with Yiqi Yangyin Zhixue Decoction for 12 weeks.The changes of platelet count,TCM syndrome score,peripheral blood T-lymphocyte subsets(CD_(3)^(+),CD_(4)^(+),CD_(8)^(+),CD_(4)^(+)/CD_(8)^(+))were observed and recorded before and after treatment.Results:1.The total effective rate of western medicine was 76%.The platelet count of the treatment group was increased before and after treatment,and the bleeding was improved significantly(P<0.05).2.The total effective rate of TCM syndrome improvement was 84%,and there was significant difference between before and after treatment of the treatment group(P<0.05).3.The T cells expressed in peripheral blood of the children in the treatment group were not significantly different from the normal controlled group.Conclusion:Yiqi Yangyin Zhixue Decoction can effectively improve the bleeding symptoms of children with Qi-Yin and deficiency syndrome,and increase the peripheral platelet count,and effectively improve the TCM syndrome of children with cITP.