本文選題：慢性再障　切入點(diǎn)：滋髓生血膠囊　出處：《河南中醫(yī)藥大學(xué)》2016年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:通過(guò)觀察滋髓生血膠囊治療慢性再生障礙性貧血患者的臨床癥狀、體征、外周血象及骨髓造血組織容量的變化情況,探討院內(nèi)制劑滋髓生血膠囊在治療慢性再生障礙性貧血中的作用機(jī)制。方法:1.將2013年12月至2015年10月期間在河南省中醫(yī)院血液科就診的60例符合納入標(biāo)準(zhǔn)的慢性再障患者隨機(jī)分作為治療組和對(duì)照組,每組各有30例患者組成。治療組采用滋髓生血膠囊聯(lián)合環(huán)孢素膠囊和司坦唑醇片口服治療,對(duì)照組口服西藥環(huán)孢素膠囊和司坦唑醇片治療,每3個(gè)月作為一個(gè)療程,共計(jì)觀察2個(gè)療程后判斷療效。2.兩組患者均于治療前、治療后由全自動(dòng)血液分析儀檢查外周血血細(xì)胞數(shù)目;骨髓活檢顯微鏡下觀察骨髓造血組織,并比較兩組患者治療前后的癥狀體征、中醫(yī)癥候、外周血細(xì)胞計(jì)數(shù)和骨髓造血組織容量的變化情況。并對(duì)患者治療前、后分別行心電圖、肝腎功能等安全性指標(biāo)檢查。3.對(duì)獲得數(shù)據(jù)采用SPSS18.0數(shù)據(jù)統(tǒng)計(jì)分析軟件進(jìn)行處理,對(duì)計(jì)數(shù)資料采用χ2檢驗(yàn),對(duì)于計(jì)算等級(jí)數(shù)據(jù)資料則采用Ridit分析,經(jīng)檢驗(yàn)服從正態(tài)分布后計(jì)量資料使用配對(duì)樣本或獨(dú)立樣本t檢驗(yàn),顯著性概率值設(shè)為0.05,對(duì)于定量統(tǒng)計(jì)數(shù)據(jù)全部采用以(?)±s表示,而對(duì)于定性資料采用計(jì)算構(gòu)成比的方法進(jìn)行分析。結(jié)果:1.臨床療效對(duì)比結(jié)果:治療組:無(wú)效數(shù)、明顯進(jìn)步數(shù)、緩解數(shù)、基本治愈數(shù)分別為3、11、13、3,有效率達(dá)到90%;對(duì)照組分別為8、12、10、0,有效率達(dá)到73.33%;使用數(shù)據(jù)統(tǒng)計(jì)軟件分析得出:治療組的有效率明顯大于對(duì)照組的有效率(P0.05),治療后治療組和對(duì)照組的有效率相比差異性顯著。2.外周血細(xì)胞對(duì)比分析:治療組和對(duì)照組的紅細(xì)胞數(shù)、白細(xì)胞數(shù)、血小板數(shù)目治療后均較治療前顯著升高(P0.05),治療組較對(duì)照組外周血細(xì)胞數(shù)升高顯著。3.對(duì)骨髓造血組織容量數(shù)據(jù)對(duì)比分析:治療組的骨髓造血組織容量和對(duì)照組相比,在治療后較治療前增加更為顯著(P0.05),并且治療后兩組間相比治療組造血組織容量升高程度明顯高于對(duì)照組。4.中醫(yī)相關(guān)癥候療效對(duì)比分析結(jié)果:治療組臨床無(wú)效、有效、顯效、痊愈例數(shù)分別為2、9、15、4;對(duì)照組分別為7、11、10、2;兩組各自總的有效率分別為93.33%、76.67%;治療組總有效率顯著高于對(duì)照組(P0.05),有統(tǒng)計(jì)學(xué)意義,兩組中醫(yī)癥候總有效率治療后差異性明顯,在中醫(yī)相關(guān)癥候療效上治療組和對(duì)照組相比,治療組療效明顯。結(jié)論:滋髓生血膠囊聯(lián)合西藥可明顯改善慢性再障患者的臨床癥狀,改善外周血象,增加骨髓造血面積,并且效果優(yōu)于單獨(dú)使用西藥治療,臨床療效值得肯定;滋髓生血膠囊聯(lián)合西藥對(duì)改善患者的中醫(yī)癥候明顯優(yōu)于單純使用西藥治療;可見滋髓生血膠囊聯(lián)合西藥比單獨(dú)使用西藥治療能夠更顯著地改善再障患者外周血象和骨髓造血組織容量及相關(guān)中醫(yī)癥候,從而取得了滿意的臨床效果。
[Abstract]:Objective: to observe the changes of clinical symptoms, signs, peripheral blood images and bone marrow hematopoietic tissue volume in patients with chronic aplastic anemia treated with Ziwei Shengxue capsule. To explore the mechanism of the hospital preparation Zijiu Shengxue capsule in the treatment of chronic aplastic anemia. Methods: 1. 60 cases of chronic aplastic anemia treated in Department of Hematology, Henan Provincial Hospital of traditional Chinese Medicine from December 2013 to October 2015 were included in the study. Patients with aplastic anemia were randomly divided into treatment group and control group. Each group consisted of 30 patients. The treatment group was treated by oral administration of Zimai Shengxue capsule combined with cyclosporine capsule and steazolol tablet, while the control group was treated with western medicine cyclosporine capsule and steazolol tablet every 3 months as a course of treatment. After two courses of treatment, the patients in both groups were examined for the number of peripheral blood cells by automatic blood analyzer before and after treatment, and the bone marrow hematopoietic tissue was observed under bone marrow biopsy microscope. The changes of symptoms and signs, TCM symptoms, peripheral blood cell count and bone marrow hematopoietic tissue volume before and after treatment were compared between the two groups. The safety indexes such as liver and kidney function were examined. The acquired data were processed by SPSS18.0 data statistical analysis software, the count data were analyzed by 蠂 2 test, and the data of calculating grade data were analyzed by Ridit. After normal distribution, the measurement data were tested by paired sample or independent sample t test. The significant probability value was set to 0.05. ) 鹵s, and the qualitative data were analyzed using the method of calculating the constituent ratio. Results: 1. Clinical efficacy comparison results: treatment group: invalid number, significant improvement number, remission number, The number of basic cure was 3 1 / 1 / 13 / 3, the effective rate was 90 and the control group was 812 / 10 / 10 and the effective rate was 73.330.Using statistical analysis of data, the results showed that the effective rate of the treatment group was significantly higher than that of the control group (P 0.05), and that of the treatment group and the control group after treatment was significantly higher than that of the control group (P < 0.05). Comparative analysis of peripheral blood cells: the number of red blood cells in the treatment group and the control group, The number of leukocytes and platelets after treatment were significantly higher than those before treatment, and the number of peripheral blood cells in the treatment group was significantly higher than that in the control group. The data of hematopoietic tissue capacity of bone marrow in the treatment group were compared with that in the control group, and the hematopoietic tissue capacity of the treatment group was higher than that of the control group. After treatment, the increase of hematopoietic tissue volume in the treatment group was significantly higher than that in the control group. The results showed that the clinical efficacy of the treatment group was ineffective, effective and effective, and that of the treatment group was significantly higher than that of the control group. The total effective rate of the two groups was 93.33 and 76.67 respectively. The total effective rate of the treatment group was significantly higher than that of the control group (P 0.05), and the difference of the total effective rate of the two groups after the treatment was obvious, and the total effective rate of the treatment group was significantly higher than that of the control group (P 0.05), and the total effective rate of the two groups was significantly higher than that of the control group (P 0.05). Compared with the control group, the therapeutic effect of the treatment group is more obvious than that of the control group. Conclusion: the treatment group can obviously improve the clinical symptoms, improve the peripheral blood picture and increase the bone marrow hematopoiesis area of the patients with chronic aplastic anemia. And the effect is better than using western medicine alone, the clinical curative effect is worthy of affirmation, the combination of Zijiu Shengxue capsule and western medicine is obviously superior to the simple use of western medicine to improve the symptoms of traditional Chinese medicine. It can be seen that the combination of Ziwei Shengxue capsule and western medicine can significantly improve the peripheral blood picture bone marrow hematopoietic tissue volume and related TCM symptoms of patients with aplastic anemia compared with the treatment of western medicine alone. Thus satisfactory clinical results have been obtained.
【學(xué)位授予單位】：河南中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2016
【分類號(hào)】：R259

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