肿节风联合小剂量强的松治疗原发性免疫性血小板减少症的临床观察

目的:观察肿节风联合小剂量强的松治疗原发性免疫性血小板减少症(primary immune thrombocytopenia,ITP)的安全有效性。方法:60例ITP患者随机分为两组:对照组30例,采用"标准剂量强的松"方案治疗;观察组30例,采用"肿节风~+小剂量强的松"方案治疗。比较两组患者血小板数和T-淋巴细胞亚群的变化情况及毒副作用。结果:对照组的总有效率(63.33%)低于观察组(86.67%),差异有统计学意义(P<0.05);两组患者经治疗后的血小板计数明显升高,且观察组治疗14 d、1个月、2个月、3个月后的血小板计数均高于对照组,差异均有统计学意义(P<0.05);两组治疗后的淋巴细胞群、CD3~+CD4~-CD8~+、CD19~+显著下降,且观察组低于对照组(P<0.05),CD3~+、CD3~+CD4~+CD8~-、CD3~-CD16~+56~+显著升高,且观察组高于对照组(P<0.05);对照组总不良反应发生率(33.33%)高于观察组(10.00%),差异有统计学意义(P<0.05)。结论:肿节风联合小剂量强的松治疗ITP能更有效地提高血小板计数、T-淋巴细胞亚群水平,还可避免因使用强的松引起的毒副作用。

Clinical observation of Herba Sarcandrae combined with low-dose prednisone in the treatment of primary immune thrombocytopenia

Objective:To observe the effect and safety of Herba Sarcandrae combined with low-dose prednisone in the treatment of primary immune thrombocytopenia (ITP).Methods:60 cases of ITP patients were randomly divided into the observation group (30cases) and the control group (30 cases),the control group was given standard-dose prednisone,and the observation group was given Herba Sarcandrae combined with low-dose prednisone.The changes in platelet and T cell subsets and side-effects were observed and recorded.Results:The total effective rate in the control group was significantly lower than that in the observation group (63.33％ vs.86.67％),The difference was statistically significant(P ＜ 0.05),the platelet count was significantly increased after treatment in two groups,and platelet count after 14 days,1 months.,2 months,3 months treatment in the observation group were significantly higher than that in the control group,the difference was statistically significant (P ＜0.05);The lymphocytes,CD3 + CD4-CD8 + and CD19 + cells significantly decreased after treatment in two groups,CD3 + CD4-CD8 + and CD19 + cells in the observation group were significantly lower than that in the control group (P ＜ 0.05).The CD3 +,CD3 + CD4 + CD8-and CD3-CD16 + 56 + cells significantly increased,and these in the observation group were significantly higher than that in the control group(P ＜ 0.05).The total incidence of adverse reactions in the control group was significantly higher than that in the observation group (33.33％ vs.10.00％),the difference was statistically significant (P ＜ 0.05).Conclusion:Herba Sarcandrae combined with low-dose prednisone in the treatment of ITP could effectively increase the platelet count,regulate T cell subsets,and also can avoid the side-effects caused by use of high-dose prednisone.