补气生血法二线治疗免疫性血小板减少症的临床研究

Clinical Study of Second-line Treatment of Immune Thrombocytopenia with Qi-tonifying and Blood-generating Therapy

目的探讨补气生血法二线治疗免疫性血小板减少症(ITP)的疗效和安全性。方法选择2016年11月1日—2021年10月31日在重庆市梁平区人民医院肿瘤血液科就诊的ITP患者,回顾性分析应用补气生血法二线治疗ITP的疗效和不良反应。结果84例ITP患者接受补气生血法治疗,有效率为77.4%,完全缓解率为71.4%,中位反应时间为8周。组间分析,复发性ITP与难治性、类固醇依赖性ITP相比反应率差异具有统计学意义[OR=3.882,95%CI(1.338,11.268),P=0.014];开始治疗时血小板计数≥15×109/L和血小板计数<15×109/L患者之间的反应率差异具有统计学意义[OR=3.333,95%CI(2.997,38.918),P=0.000]。同时,应用类固醇激素的80例患者中,有40例(50.0%)接受补气生血法治疗后停用类固醇激素。治疗中,2例患者出现腹泻,未影响继续治疗。结论采用补气生血法治疗复发性ITP有效且患者可耐受。

Objective To evaluate the efficacy and safety of qi-tonifying and blood-generating therapy in the treatment of immune thrombocytopenia(ITP).Methods ITP patients admitted to the Oncology and Hematology Department of the People's Hospital of Liangping District,Chongqing,from November 1,2016,to October 31,2021,were enrolled in this study.The efficacy and side effects of qi-tonifying and blood-generating therapy in the treatment of ITP were retrospectively analyzed Results Eighty-four patients with ITP were treated with qi-tonifying and blood-generating therapy,with an effective rate of 77.4%,a complete relief rate of 71.4%,and a median response time of eight weeks.The inter-group analysis showed that the response rate of relapsed ITP was different from that of refractory and steroid-dependent ITP[OR=3.882,95%CI(1.338,11.268),P=0.014].At the beginning of treatment,there was a significant difference in response rate between patients with the blood platelet count of≥15×10^(9)/L and patients with the blood platelet count of<15×10^(9)/L[OR=3.333,95%CI(2.997,38.918),P=0.000)].In the 80 patients treated with steroid hormone,40(50.0%)were discontinued after receiving the qi-tonifying and blood-generating therapy.Diarrhea occurred in two patients during the treatment and did not affect the treatment.Conclusion The qi-tonifying and blood-generating therapy is effective and tolerable in the treatment of relapsed ITP.