發(fā)布時(shí)間：2018-01-08 04:02

  本文關(guān)鍵詞：益氣養(yǎng)陰健脾清熱組方治療慢性免疫性血小板減少癥的療效分析　出處：《南京中醫(yī)藥大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

  更多相關(guān)文章： 慢性免疫性血小板減少癥(cITP) 益氣養(yǎng)陰 健脾 清熱 療效分析

【摘要】：目的:探討益氣養(yǎng)陰健脾清熱組方治療慢性免疫性血小板減少癥(Chronic Immune Thrombocytopenia,cITP)的療效分析。方法:臨床納入了 2015.12-2016.12期間來自江蘇省中醫(yī)院血液科病房及血液科專科門診的72例cITP患者。72例患者中兒童組30例,中藥組15例,中西醫(yī)組15例;成人組42例,中藥組24例,中西醫(yī)組18例。中藥組予益氣養(yǎng)陰健脾清熱組方(炙黃芪15g、熟地黃15g、水牛角15g先煎、仙鶴草15g、腫節(jié)風(fēng)15g、羊蹄根15g、蒲黃炭15g、三七粉3g沖服、茯苓15g、焦白術(shù)15g、知母10g、連翹10g、炙升麻6g),就診時(shí)正在服用糖皮質(zhì)激素者和既往使用糖皮質(zhì)激素治療有效者可繼續(xù)規(guī)范用藥并根據(jù)病情緩解情況逐漸撤減糖皮質(zhì)激素用量。以4周為1療程,觀察至少3個(gè)療程,比較各組每療程治療前后血小板計(jì)數(shù)、臨床治療總反應(yīng)率、糖皮質(zhì)激素撤減劑量。結(jié)果:兒童組30例患者,15例中藥組患者治療3療程后臨床治療總反應(yīng)率為86.67%,血小板計(jì)數(shù)由治療前(29.40±20.22)×109/L升至(59.33±38.31)×109/L。3療程后15例中西醫(yī)組患者臨床治療總有效率為80.00%,血小板計(jì)數(shù)由治療前(39.60±29.09)×109/L升至(67.67±29.34)×109/L。兩組內(nèi)3療程血小板計(jì)數(shù)均較治療前有顯著性提高,差異均有統(tǒng)計(jì)學(xué)意義(P0.05),兩組間3療程臨床治療總反應(yīng)率均無差異(P0.05)。成人組42例患者,24例中藥組患者在治療3療程后臨床治療總有效率87.50%,血小板計(jì)數(shù)由治療前(23.96±15.21)×109/L升至(48.67±23.03)×109/L。3療程后18例中西醫(yī)組患者臨床治療總有效率為83.33%,血小板計(jì)數(shù)由治療前(44.72±29.81)×109/L升至(77.28±45.04)×109/L。兩組內(nèi)3療程血小板計(jì)數(shù)均較治療前有顯著性提高,差異均有統(tǒng)計(jì)學(xué)意義(P0.05),兩組間3療程臨床治療總反應(yīng)率無差異(P0.05)。全部中藥組共39例患者,治療3療程后臨床治療總反應(yīng)率87.18%,血小板計(jì)數(shù)由治療前(26.05±17.26)×109/L升至(52.77±29.77)×109/L。全部中西醫(yī)組33例患者3療程后臨床治療總反應(yīng)率為 81.82%,血小板計(jì)數(shù)由治療前(42.39±29.14)×109/L 升至(72.91±38.44)×109/L。兩組內(nèi)3療程血小板計(jì)數(shù)均較治療前有顯著性提高,差異均有統(tǒng)計(jì)學(xué)意義(P0.05),兩組間3療程臨床治療總反應(yīng)率均無差異(P0.05)。兒童中西醫(yī)組糖皮質(zhì)激素劑量由治療前10.42±5.54mg減至3.17±3.12mg,成人中西醫(yī)組糖皮質(zhì)激素劑量由治療前18.12±17.37mg減至4.38±3.44mg,全部中西醫(yī)組糖皮質(zhì)激素劑量由治療前14.62±13.75mg減至3.83±3.31mg,三組激素變化水平均較治療前有顯著性降低,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論:本次研究結(jié)果證明益氣養(yǎng)陰健脾清熱組方具有良好的臨床療效,可以有效提高兒童及成人cITP患者血小板計(jì)數(shù)及臨床治療總反應(yīng)率,并協(xié)助激素撤減,改善出血癥狀。
[Abstract]:Objective: To investigate the effect of Jianpi Qingre Yiqi Yangyin prescription in treatment of chronic immune thrombocytopenia (Chronic Immune, Thrombocytopenia, cITP). Methods: clinical efficacy analysis included 2015.12-2016.12 from Jiangsu Province Traditional Chinese Medicine Hospital Department of Hematology and Department of hematology ward during the clinic of 72 cases of patients with cITP.72 patients in children group 30 cases, 15 cases of Chinese medicine group, 15 cases in the group of Chinese and Western adult medicine; group 42 cases, 24 cases of Chinese medicine group, 18 cases in the group of traditional Chinese medicine and Western medicine. Chinese medicine group were treated with Yiqi Yangyin prescription Jianpi Qingre (Radix Astragali 15g, Radix Rehmanniae 15g, water buffalo 15g decocted, agrimony 15g, swelling wind 15g, Bauhinia root 15g, 15g powder 3G 37 pollen Typhae Carbonisatus, Chongbo, Fuling 15g 15g 10g, coke Atractylodes, Rhizoma Anemarrhenae, forsythia 10g, 6g), foreman cohosh treatment when taking glucocorticoids and previous use of glucocorticoid therapy can effectively continue to regulate drug according to the remission of glucocorticoid with reduced gradually. . 4 weeks as 1 course of treatment, observation of at least 3 cycles were compared before and after each course of treatment of platelet count, the total reaction rate of clinical treatment, glucocorticoid withdrawal dose. Results: 30 cases of children group, 15 cases of Chinese medicine group after 3 courses of treatment the total response rate was 86.67% for clinical treatment, platelet count from before treatment (29.40 + 20.22) * 109/L to (59.33 + 38.31) * 109/L.3 after treatment of 15 cases of traditional Chinese medicine and Western medicine group clinical total effective rate was 80%, the platelet count before treatment (39.60 + 29.09) * 109/L to (67.67 + 29.34) * 109/L. two group 3 course of treatment compared with the platelet count before treatment increased significantly, there were statistically significant differences between the two groups (P0.05), the 3 course of treatment the total response rate was not significantly different (P0.05). 42 cases of adult group, 24 cases of traditional Chinese medicine in the treatment of patients after 3 courses of treatment of the total efficiency of 87.50%, the platelet count before treatment (23.96 X + 15.21) 109/L to (48.67 + 23.03) * 109/L.3 after treatment of Western medicine group of 18 patients in the clinical treatment of patients with the total effective rate was 83.33%, the platelet count before treatment (44.72 + 29.81) * 109/L to (77.28 + 45.04) * 109/L. two group 3 course of platelet count was significantly higher than before treatment significantly increased, there were statistically significant differences between the two groups (P0.05), the total reaction rate had no difference in the clinical treatment of 3 courses (P0.05). All the Chinese medicine group of 39 patients, after 3 courses of treatment, the total response rate was 87.18% for clinical treatment, the platelet count before treatment by (26.05 + 17.26) * 109/L (52.77 + 29.77) to rise * 109/L. all the traditional Chinese and Western medicine group of 33 patients after 3 courses of treatment the total reaction rate was 81.82%, the platelet count before treatment (42.39 + 29.14) * 109/L to (72.91 + 38.44) * 109/L. two group 3 course of platelet count were significantly improved, the differences were statistically significant (P0.05), Between the two groups 3 course of clinical treatment of the total reaction rate had no significant difference (P0.05). The children of Chinese and Western medicine glucocorticoid dose group from 10.42 before treatment to 3.17 + 5.54mg + 3.12mg, adult group of traditional Chinese medicine and Western medicine glucocorticoid dose from 18.12 before treatment to 4.38 + 17.37mg + 3.44mg, all the traditional Chinese medicine and Western medicine glucocorticoid group the dose from 14.62 before treatment to 3.83 + 13.75mg + 3.31mg, the hormone levels of three groups were significantly decreased, the difference was statistically significant (P0.05). Conclusion: the results of this study prove that Jianpi Qingre Yiqi Yangyin prescription has good curative effect, can effectively improve the overall response of children and adults with cITP platelet count and clinical cure rate and help improve hormone withdrawal bleeding symptoms.

【學(xué)位授予單位】：南京中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R259

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 王海燕;王華;姚召;趙莉;耿少怡;焦平;;通脈止血方治療小兒免疫性血小板減少性紫癜30例療效觀察[J];中國現(xiàn)代藥物應(yīng)用;2016年15期

2 黃振東;于志峰;戴錫孟;武學(xué)潤;;寧血升板湯聯(lián)合潑尼松治療特發(fā)性血小板減少性紫癜與潑尼松等效性多中心隨機(jī)平行對(duì)照研究[J];實(shí)用中醫(yī)內(nèi)科雜志;2016年07期

3 楊玉瑤;韓娟;林鳴;金潤銘;;槐杞黃顆粒聯(lián)合經(jīng)典方案治療兒童免疫性血小板減少癥的療效觀察[J];中國小兒血液與腫瘤雜志;2016年03期

4 凌仕良;許亞梅;石鳳琴;;許亞梅教授治療免疫性血小板減少癥經(jīng)驗(yàn)[J];福建中醫(yī)藥;2016年02期

5 褚雨霆;陳信義;李天天;陳科;侯麗;;運(yùn)用脾統(tǒng)血理論指導(dǎo)免疫性血小板減少性紫癜臨床治療[J];中華中醫(yī)藥雜志;2016年04期

6 陸泳萍;;養(yǎng)血和血方治療免疫性血小板減少性紫癜的療效研究及對(duì)細(xì)胞因子、血小板參數(shù)的影響[J];河北中醫(yī)藥學(xué)報(bào);2016年01期

7 孫鳳;倪虹;郝晶;;紫茜合劑治療慢性原發(fā)免疫性血小板減少癥療效觀察[J];山東中醫(yī)雜志;2016年03期

8 何紅珍;黨蕓芝;魏文婷;馮小榮;;裴正學(xué)治療特發(fā)性血小板減少性紫癜經(jīng)驗(yàn)[J];世界中西醫(yī)結(jié)合雜志;2016年01期

9 趙沙沙;周延峰;;周延峰治療免疫性血小板減少性紫癜經(jīng)驗(yàn)[J];湖南中醫(yī)雜志;2016年01期

10 向金峰;;涼血逐瘀湯治療慢性特發(fā)性血小板減少性紫癜臨床研究[J];中藥藥理與臨床;2015年06期

，

本文編號(hào)：1395508