本文選題：兩地升血湯　切入點：慢性再生障礙性貧血　出處：《湖南中醫(yī)藥大學(xué)》2016年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:觀察兩地升血湯對慢性再生障礙性貧血(CAA)患者臨床癥狀、中醫(yī)癥候、血象、網(wǎng)織紅細(xì)胞計數(shù)、外周血淋巴細(xì)胞亞群比例、骨髓象的影響,評價其治療慢性再生障礙性貧血的療效和安全性,揭示出兩地升血湯治療CAA的優(yōu)勢,為臨床應(yīng)用及實驗研究提供依據(jù),為中醫(yī)藥治療慢性再生障礙性貧血做出貢獻。方法:將60例慢性再生障礙性貧血(CAA)患者隨機分為中藥方劑組和西藥對照組,中藥方劑組30例,西藥對照組30例,中藥方劑組采用兩地升血湯中藥煎劑治療;西藥對照組采用環(huán)孢素A、安雄口服治療,治療療程兩組都為6個月。觀察臨床療效,并檢測兩組患者治療前后血象、網(wǎng)織紅細(xì)胞計數(shù)、外周血淋巴細(xì)胞亞群比例、骨髓象水平。結(jié)果:中藥方劑組西醫(yī)臨床總有效率為86.7%,西藥對照組總有效率為80.0%,兩組均可以有效的提高慢性再生障礙性貧血患者的血象,經(jīng)統(tǒng)計無顯著性差異(P0.05)。對中藥方劑組與西藥對照組改善中醫(yī)癥候療效進行比較,中藥方劑組總有效率90.0%,西藥對照組總有效率為53.3%,經(jīng)檢驗兩組差異有統(tǒng)計學(xué)意義(P0.05),表明中藥方劑組在改善患者中醫(yī)臨床癥狀方面明顯優(yōu)于西藥對照組;且中藥方劑組與西藥對照組均可提升CAA患者血象,且中藥方劑組較西藥對照組效果更明顯。并可有效調(diào)節(jié)CAA患者T淋巴細(xì)胞亞群CD4+、CD8+水平,且效果相當(dāng)。治療后,對兩組骨髓有核紅細(xì)胞比例、中性粒細(xì)胞比例、淋巴細(xì)胞比例、巨核細(xì)胞計數(shù)進行組間比較,經(jīng)檢驗,除巨核細(xì)胞比較差異無統(tǒng)計學(xué)意義,余各項比較差異有統(tǒng)計學(xué)意義。提示中藥方劑組與西藥對照組均可促進再障患者骨髓造血,且中藥方劑組較西藥對照組效果更明顯。中藥方劑組治療安全性較好,無明顯毒副作用,不良反應(yīng)發(fā)生率低。結(jié)論:1.兩地升血湯治療CAA有確切療效。2.兩地升血湯可以有效提升患者外周血象及網(wǎng)織紅細(xì)胞計數(shù)、促進骨髓造血,有效調(diào)節(jié)CAA患者T淋巴細(xì)胞亞群CD4+、CD8+,其具體作用機制有待于進一步探討研究。3.兩地升血湯治療CAA安全可靠,無明顯毒副作用,不良反應(yīng)發(fā)生率低。
[Abstract]:Objective: to observe the effects of Shengxue decoction on the clinical symptoms, traditional Chinese medicine symptoms, hemogram, reticulocyte count, lymphocyte subsets in peripheral blood and bone marrow in patients with chronic aplastic anemia (CAA). To evaluate its efficacy and safety in the treatment of chronic aplastic anemia, to reveal the advantages of Shengxue decoction in treating CAA, and to provide the basis for clinical application and experimental study. Methods: 60 patients with chronic aplastic anemia were randomly divided into traditional Chinese medicine (TCM) group and western medicine control group (n = 30) and control group (n = 30). The traditional Chinese medicine prescription group was treated with traditional Chinese medicine decoction of both places of Shengxue decoction, and the western medicine control group was treated with cyclosporine A and Anxiong orally for 6 months. The clinical curative effect was observed and the blood picture of the two groups was detected before and after treatment. Reticulocyte count, lymphocyte subsets in peripheral blood, Results: the total effective rate of western medicine was 86.7 in the traditional Chinese medicine prescription group, and the total effective rate in the western medicine control group was 80.0. Both groups could effectively improve the blood picture of the patients with chronic aplastic anemia. There was no significant difference in statistics (P 0.05). The effects of traditional Chinese medicine prescription group and western medicine control group on improving TCM symptoms were compared. The total effective rate of traditional Chinese medicine prescription group was 90.0 and that of western medicine control group was 53.3.The difference between the two groups was statistically significant (P 0.05), which indicated that the traditional Chinese medicine prescription group was obviously superior to the western medicine control group in improving the clinical symptoms of Chinese medicine. The Chinese medicine prescription group and the western medicine control group could enhance the blood picture of CAA patients, and the effect of traditional Chinese medicine prescription group was more obvious than that of western medicine control group, and it could effectively regulate the level of CD4 CD8 in T lymphocyte subsets of CAA patients, and the effect was similar after treatment. The ratio of nucleated erythrocytes, neutrophils, lymphocytes and megakaryocytes in bone marrow were compared between the two groups. The results showed that there was no significant difference between the two groups except megakaryocytes. It was suggested that both the Chinese medicine prescription group and the western medicine control group could promote hematopoiesis in the bone marrow of the patients with aplastic anemia, and the effect of the traditional Chinese medicine prescription group was more obvious than that of the western medicine control group. There were no obvious side effects, and the incidence of adverse reactions was low. Conclusion (1) Liangshengxue decoction is effective in the treatment of CAA. 2. Shengxue decoction can effectively promote peripheral blood count and reticulocyte count, and promote bone marrow hematopoiesis. The specific mechanism of regulating T lymphocyte subsets (CD4 / CD8) in patients with CAA needs to be further studied. 3. It is safe and reliable to treat CAA with Shengxue decoction and has no obvious side effects, and the incidence of adverse reactions is low.
【學(xué)位授予單位】：湖南中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2016
【分類號】：R259

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