中西医结合治疗阵发性睡眠性血红蛋白尿36例临床观察

THE CLINICAL OBSERVATION ON PATIENTS(36CASES) WITH PAROXYSMAL NOCTURNAL HEMOGLOBINURIA TREATED WITH METHOD OF COMBINATION OF TCM AND WESTERN MEDICIN

为提高阵发性睡眠性血红蛋白尿的临床疗效,采用中西医结合的方法治疗该病患者36例,中医辨证分为肝肾阴虚、淤血湿热内停型和脾肾阳虚、淤血寒湿内停型,治疗以大菟丝子饮为基础方加减;溶血急性期治以茵陈五苓散合二至丸加减,各型同时服免疫丸。西药治以强地松、维生素E、康力龙等。临床以血红蛋白尿、周围血象、骨髓增生改善情况为观察指标。结果:近期明显进步者22例,近期进步者7例,无效4例,死亡3例,总有效率为80.56 ％。同时检测了36例患者治疗前后周围血象的变化,白细胞总数、血小板、网织红细胞治疗后均有改善的趋势,血红蛋白较治疗前明显上升,经统计学处理,治疗前后有非常显著的差异(t=8.51P<0.01)。

Inorder to improve the curative effects of paroxysmal nocturnal hemoglobinuria, treated patients (36 cases) with the method of combination of TCM and western medicine. Classifying according to the differentation of syndrome: deficiency of liver-yin and kidney-yin, stagnation of stasis blood and damp-cold, deficiency of spleen-yang. The accumulation of stasis blood and damp-cold, treated with 'Datusizhiyin' modefying; the stage of acute hemolysis treated with 'yinchenwulingsan' and 'Erziwan' modefying, meanwhile taking immune pill and western medicine Prednisone, Vitmine E and Stanozoiol, etc. The observation indexes were PNH, cytometry and improvment of myeloproliIerative. The result showed that improvment obvious in a short time, 22 cases; improvment in a short time, 7 cases; ineffective, 4 cases; dead, 3 cases, the general effectiveness rate was 80.56%, meanwhile examing the changes of cytometry of patients (36 cases) the number of WBC, PLTS and RT improved, Hb increased obviously, the difference between no-treat and treat was obvious. (P<0.01)