温和灸联合醋酸泼尼松治疗气不摄血型免疫性血小板减少症的疗效观察

Effect of gentle moxibustion combined with Prednisone acetate on immune thrombocytopenia with Qi failing to contain blood pattern

目的观察温和灸联合醋酸泼尼松治疗气不摄血型免疫性血小板减少症(immune thrombocytopenia,ITP)的临床疗效。方法将66例气不摄血型ITP患者随机分为对照组和观察组,每组33例。对照组予口服醋酸泼尼松治疗,观察组予温和灸联合口服醋酸泼尼松治疗。观察两组治疗前后外周血血小板计数、出血评分、慢性病治疗功能评估-疲劳量表(functional assessment of chronic illness therapy-fatigue,FACIT-F)评分、ITP患者生活质量评估量表(ITP patient assessment questionnaire,ITP-PAQ)评分及血清白介素-10(interleukin-10,IL-10)和白介素-33(interleukin-33,IL-33)水平的变化。比较两组临床疗效。结果观察组总有效率高于对照组(P<0.05)。两组治疗后外周血血小板计数和出血评分均较治疗前改善(P<0.05),且观察组优于对照组(P<0.05)。两组治疗后FACIT-F和ITP-PAQ评分均升高(P<0.05),且观察组高于对照组(P<0.05)。两组治疗后血清IL-10和IL-33水平均改善(P<0.05),且观察组优于对照组(P<0.05)。结论温和灸联合醋酸泼尼松治疗气不摄血型ITP临床疗效优于单一醋酸泼尼松治疗,可升高外周血血小板计数,改善出血症状、疲劳程度和生活质量,可能与其调节血清IL-10和IL-33水平有关。

Objective To observe the clinical efficacy of gentle moxibustion combined with prednisone acetate in the treatment of immune thrombocytopenia(ITP)with Qi failing to contain blood pattern.Method Sixty-six patients with ITP due to Qi failing to contain blood pattern were randomly divided into a control group and an observation group,with 33 cases in each group.The control group was treated with oral prednisone acetate,and the observation group was treated with gentle moxibustion combined with oral prednisone acetate.The platelet count,bleeding score,functional assessment of chronic illness therapy-fatigue scale(FACIT-F)score,ITP patient assessment questionnaire(ITP-PAQ)score,serum interleukin-10(IL-10)and interleukin-33(IL-33)levels were observed before and after treatment in the two groups.The clinical efficacy was compared between the two groups.Result The total effective rate of the observation group was higher than that of the control group(P<0.05).The peripheral blood platelet count and bleeding score improved in both groups after treatment compared with those before treatment(P<0.05),and they were better in the observation group than in the control group(P<0.05).The FACIT-F and ITP-PAQ scores increased in both groups after treatment(P<0.05),and they were higher in the observation group than in the control group(P<0.05).The serum IL-10 and IL-33 levels improved in both groups after treatment(P<0.05),and they were better in the observation group than in the control group(P<0.05).Conclusion The clinical efficacy of gentle moxibustion combined with prednisone acetate in the treatment of ITP with Qi failing to contain blood pattern was better than that of prednisone acetate alone,as shown by the increase in peripheral platelet count,improvement in bleeding symptoms,fatigue and quality of life,which may be related to the regulation of serum IL-10 and IL-33 levels.