基于“补肾生髓成肝”法则治疗肝硬化血小板减少的临床观察

Clinical observation on the treatment of thrombocytopenia in liver cirrhosis based on the principle of "tonifying the kidney to promote liver regeneration and repair by effecting stem cells and their microenvironment"

目的:观察补肾生髓成肝法则治疗肝硬化血小板减少患者的临床疗效。方法:选取86例肝硬化脾功能亢进血小板减少患者作为第1组研究,“补肾生髓成肝”治疗组和对照组各43例;同时选取32例肝硬化脾功能亢进脾脏切除后血小板再减少患者作为第2组研究,“补肾生髓成肝”治疗组和对照组各16例。对照组患者给予保肝、抗病毒等常规治疗。“补肾生髓成肝”治疗组患者在对照组治疗的基础上给予地五养肝方与左归丸合方化裁、辨证加减,比较两组患者的治疗效果。结果:在第1组及第2组研究中,“补肾生髓成肝”治疗组患者疗效均明显优于对照组,且各组患者未发生明显不良反应。结论:以“补肾生髓成肝”法则治疗肝硬化血小板减少症具有较好临床疗效,其可能的机制与改善肝脏微环境,减低减缓肝炎病毒介导的自身免疫反应,改善骨髓的造血功能,促进血小板生成素的分泌等有关。

Objective:To observe the clinical effect of“tonifying the kidney to promote liver regeneration and repair by effecting stem cells and their microenvironment”(Diwu Yanggan prescription combined with Zuogui pill syndrome differentiation addition and reduction,abbreviation:DWYG-ZGW)in the treatment of cirrhosis thrombocytopenia.Methods:86 cases of liver cirrhosis with hyperplenia thrombocytopenia were selected as group 1 study,and 32 cases of liver cirrhosis with hyperplenia after splenectomy were selected as group 2 study.The two groups were randomly divided into control group and DWYG-ZGW groups with 43 cases and 16 cases respectively.The control group received conventional treatment such as liver protection and antiviral.On the basis of the treatment of the control group,the treatment group(DWYG-ZGW)was given Diwu Yanggan prescription and Zuogui pill,and the therapeutic effect of the two groups was compared.Results:The therapeutic effect on thrombocytopenia was significantly better than that of the control group in the first group and the second group,and no obvious adverse reactions were found in each group.Conclusion:"Tonifying the kidney to promote liver regeneration and repair by effecting stem cells and their microenvironment"(DWYG-ZGW)can significantly improve thrombocytopenia in cirrhosis.The possible mechanism is to improve the liver microenvironment,reduce the autoimmune response mediated by hepatitis virus,improve the hematopoietic function of bone marrow and promote the secretion of thrombopoietin.