本文選題：非重型再生障礙性貧血　切入點(diǎn)：補(bǔ)腎生髓方　出處：《山西醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的:本文旨在觀察補(bǔ)腎生髓方聯(lián)合環(huán)孢素軟膠囊和十一酸睪酮軟膠囊治療非重型再生障礙性貧血(腎陰虛型)短期臨床療效,以期判定補(bǔ)腎生髓方聯(lián)合西藥治療非重型再生障礙性貧血是否確有增效減毒作用。方法:采用隨機(jī)對(duì)照的試驗(yàn)方法,將41例患者(符合非重型再生障礙性貧血的西醫(yī)診斷標(biāo)準(zhǔn)、腎陰虛型的中醫(yī)證候診斷標(biāo)準(zhǔn),并且同時(shí)符合納入和排除標(biāo)準(zhǔn)),隨機(jī)分為兩組,治療組21例,對(duì)照組20例。治療組給予環(huán)孢素軟膠囊,3-6mg/Kg,Q12h;十一酸睪酮軟膠囊,40mg,3次/日;補(bǔ)腎生髓方150ml,2次/日,空腹溫服。對(duì)照組給予環(huán)孢素軟膠囊,3-6mg/Kg,Q12h;十一酸睪酮軟膠囊,40mg,3次/日。兩組療程均為6個(gè)月。試驗(yàn)過(guò)程中均不可用與補(bǔ)腎生髓方作用相近甚至相同的中草藥、中成藥等。觀察兩組患者治療前后外周血細(xì)胞計(jì)數(shù)[白細(xì)胞(WBC)、血紅蛋白(HB)、血小板(PLT)、網(wǎng)織紅細(xì)胞(RET)]、中醫(yī)證候(臨床癥狀)變化情況及不良反應(yīng)。結(jié)果:療效性評(píng)價(jià):(1)療效性:治療組總有效率(緩解+明顯進(jìn)步)為85.7%,對(duì)照組總有效率60.0%。二者之間存在顯著性差異(P0.05)。(2)外周血象比較(WBC、HB、PLT、RET計(jì)數(shù)):兩組患者外周血WBC、HB、PLT、RET計(jì)數(shù)在治療前和治療后均存在顯著性差異(P0.05),可認(rèn)為單用西藥組和中西藥聯(lián)合治療組對(duì)NSAA患者外周血WBC、HB、PLT、RET升高均有效,但四項(xiàng)指標(biāo)升高的程度卻有所不同:兩組治療前和治療后相對(duì)比,外周血HB和RET計(jì)數(shù)存在顯著性差異(P0.05),然而WBC和PLT數(shù)上升無(wú)顯著性差異(P0.05),即補(bǔ)腎生髓方聯(lián)合西藥治療NSAA主要對(duì)患者外周血紅系升高比較理想。(3)中醫(yī)證候:中西藥物治療組總有效率為85.7%,對(duì)照組總有效率為65.0%,兩組中醫(yī)證候?qū)Ρ炔町愑薪y(tǒng)計(jì)學(xué)意義(P0.05),可認(rèn)為補(bǔ)腎生髓方聯(lián)合西藥治療組比單用西藥對(duì)照組更能明顯改善患者中醫(yī)證候(臨床癥狀)。不良反應(yīng)比較:治療組可以減少西藥所造成的不良反應(yīng)。結(jié)論:1.中藥聯(lián)合西藥組和單用西藥組均可升高非重型再障(腎陰虛型)患者外周血WBC、HB、PLT、RET計(jì)數(shù)。2.中藥聯(lián)合西藥組在升高非重型再障(腎陰虛型)患者外周血HB、RET方面比單用西藥組療效好。3.中藥聯(lián)合西藥可明顯改善患者臨床癥狀(主要是中醫(yī)證候)。4.中藥聯(lián)合西藥可以減少不良反應(yīng)。本課題為山西醫(yī)科大學(xué)第二醫(yī)院院內(nèi)新技術(shù)新項(xiàng)目“補(bǔ)腎生髓方治療非重型再生障礙性貧血臨床觀察(編號(hào):201621)”。
[Abstract]:Objective: to observe the short-term clinical effect of Bushen Shengmai recipe combined with Cyclosporin soft capsule and testosterone undecanoate soft capsule in the treatment of non-severe aplastic anemia (kidney-yin deficiency type). The purpose of this study was to determine whether the combination of Bushenshengmai recipe and western medicine in the treatment of non-severe aplastic anemia has synergistic and detoxifying effects. Methods: a randomized controlled trial was conducted in 41 patients (in accordance with the diagnostic criteria of Western medicine for non-severe aplastic anemia). The traditional Chinese medicine syndrome diagnosis criteria of kidney yin deficiency type were randomly divided into two groups: treatment group (n = 21) and control group (n = 20). The treatment group was given cyclosporine soft capsule 3-6 mg / kg Q12h, testosterone undecanoate soft capsule 40 mg / d; Bushen Shengmai recipe 150 ml / d, The control group was given Ciclosporin soft capsule 3-6 mg / kg Q12 h and testosterone undecanoate 40 mg / day for 3 times a day. The course of treatment in both groups was 6 months. In the course of the experiment, no Chinese herbal medicine with similar or even the same effect as Bushen Shengmai recipe could be used. Observe the changes of peripheral blood cell count before and after treatment [WBC WBCU, hemoglobin HBN, PLT, reticulocyte reticulocyte (RET)], TCM syndromes (clinical symptoms) and adverse reactions. Results: curative effect evaluation. (1) Therapeutic effect: the total effective rate in the treatment group was 85.7and the total effective rate in the control group was 60.0.There was a significant difference between the two groups (P < 0.05). There were significant differences between the two groups after treatment (P 0.05). It can be concluded that both the western medicine group and the Chinese and western medicine combined treatment group are effective in increasing the level of NSAA in peripheral blood. But the levels of the four markers were different: the two groups were compared before and after treatment. There is a significant difference between HB and RET counts in peripheral blood. However, there is no significant difference in the number of WBC and PLT between them. That is to say, the combination of Bushenshengmai recipe and western medicine is more ideal for the increase of peripheral blood erythroid in patients.) TCM syndromes: Chinese and Western medicine: Chinese and western medicine. The total effective rate of the treatment group was 85.7 and the total effective rate of the control group was 65.0. The difference of TCM syndromes between the two groups was statistically significant (P 0.05). It can be concluded that the treatment group with Bushenshengmai decoction combined with western medicine can obviously improve the TCM syndrome of the patients compared with the control group of western medicine alone. (comparison of clinical symptoms and adverse reactions: the treatment group can reduce the adverse reactions caused by western medicine. Conclusion: 1. Both Chinese medicine combined with western medicine group and western medicine group can increase the peripheral blood WBCCU HBG PLTRET count in patients with non-severe aplastic anemia (kidney yin deficiency type). The therapeutic effect of traditional Chinese medicine combined with western medicine group in increasing the peripheral blood HBs RET of patients with non-severe aplastic anemia (kidney yin deficiency type) is better than that of western medicine alone. 3. The combination of traditional Chinese medicine and western medicine can obviously improve the clinical symptoms of patients (mainly TCM syndromes. 4. Traditional Chinese medicine combined with traditional Chinese medicine). Western medicine can reduce adverse reactions. This project is a new technique and new item in the hospital of the second Hospital of Shanxi Medical University, "Clinical observation of tonifying kidney and generating marrow prescription in treating non-severe aplastic anemia (no.: 201621)".
【學(xué)位授予單位】：山西醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R556.5

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 陳振領(lǐng);;益髓養(yǎng)元生血方聯(lián)合西藥治療再生障礙性貧血30例[J];中醫(yī)研究;2015年11期

2 王金環(huán);于海艷;孫鳳;欒仲秋;郝晶;劉麗波;趙偉;雍彥禮;田飛;王小東;羅正凱;賈春輝;;補(bǔ)腎填精法治療慢性髓勞病的臨床療效觀察[J];黑龍江中醫(yī)藥;2015年05期

3 劉娜;王金環(huán);孫偉正;;補(bǔ)髓生血顆粒治療慢性再生障礙性貧血患者67例[J];中國(guó)實(shí)驗(yàn)方劑學(xué)雜志;2015年16期

4 李海霞;陳楠楠;;黃世林治療再生障礙性貧血經(jīng)驗(yàn)[J];中醫(yī)雜志;2015年12期

5 莊海峰;陳美玲;魏麗萍;楊飛;胡通林;沈建平;;補(bǔ)腎法治療慢性再生障礙性貧血的臨床研究[J];中華中醫(yī)藥學(xué)刊;2014年01期

6 張會(huì)永;;李玉奇治療再生障礙性貧血經(jīng)驗(yàn)[J];中醫(yī)雜志;2013年12期

7 尹永玲;;環(huán)孢素A聯(lián)合司坦唑醇片治療慢性再生障礙性貧血的臨床療效[J];中國(guó)傷殘醫(yī)學(xué);2013年02期

8 吳迪炯;周郁鴻;;周郁鴻治療慢性再生障礙性貧血經(jīng)驗(yàn)[J];中醫(yī)雜志;2013年04期

9 秦蘭;陳信義;單麗娟;謝榮;;補(bǔ)腎填精方對(duì)再生障礙性貧血大鼠模型IL-11及EPO影響的研究[J];中國(guó)實(shí)驗(yàn)方劑學(xué)雜志;2012年08期

10 吳迪炯;周郁鴻;沈一平;;慢性再生障礙性貧血中醫(yī)認(rèn)識(shí)及優(yōu)勢(shì)進(jìn)展[J];中華中醫(yī)藥學(xué)刊;2012年03期

相關(guān)會(huì)議論文 前1條

1 張茂文;張海文;張朝閣;;“砭倉(cāng)”綜合療法治療再生障礙貧血300例[A];首屆全國(guó)砭石療法學(xué)術(shù)研討會(huì)論文集[C];2001年

，

本文編號(hào)：1675694