疏风凉血补肾方治疗慢性特发性血小板减少性紫癜临床研究.docVIP

疏风凉血补肾方治疗慢性特发性血小板减少性紫癜临床研究 　　摘要：目的 观察疏风凉血补肾方对慢性特发性血小板减少性紫癜患者（CITP）骨髓巨核细胞分化成熟及转化生长因子-β1（TGF-β1）的调节作用。方法 将50例CITP患者随机分为中药组20例、联合组15例和西药组15例。中药组以疏风凉血补肾方治疗，联合组以疏风凉血补肾方加强的松治疗，西药组以强的松为主治疗，4周为1个疗程，连续治疗3个疗程，观察临床疗效及血小板计数、骨髓巨核细胞总数和构成比例、骨髓TGF-β1水平的变化。结果 中药组良效率（55.0%，11/20）显著高于西药组（20.0%，3/15），与联合组（60.0%，9/15）相近；中药组治疗后血小板计数上升（P0.01），且优于西药组（P0.05），与联合组相似；中药组治疗后骨髓巨核细胞总数降低、产板巨核细胞比例上升（P0.01），与联合组相似，而西药组治疗前后无明显差异；中药组、联合组治疗后TGF-β1值降低（P0.05），且和西药组治疗后比较差异有统计学意义（P0.05）。结论 疏风凉血补肾方能有效降低CITP患者TGF-β1水平，促进骨髓巨核细胞分化成熟，从而有效提高血小板计数。 　　关键词：慢性特发性血小板减少性紫癜；疏风凉血补肾方；骨髓巨核细胞；分化成熟；转化生长因子-β1 　　DOI：10.3969/j.issn.1005-5304.2013.07.007 　　中图分类号：R259.546.1 文献标识码：A 文章编号：1005-5304（2013）07-0015-04 　　Clinical Study on Treatment of Chronic Idiopathic Thrombocytopenic Purpura by Expelling Wind， Cooling Blood and Invigorating Kidney Prescription ZENG Ying-jian （Wuyi Hospital of Traditional Chinese Medicine of Jiangmen， Jiangmen 529000， China） 　　Abstract：Objective To observe the effect of expelling wind， cooling blood and invigorating kidney prescription on the marrow megakaryocyte differentiation maturity and TGF-β1 in patients with chronic idiopathic thrombocytopenic purpura （CITP）. Methods Fifty CITP patients were randomly divided to three groups， including 20 patients administrated with the expelling wind， cooling blood and invigorating kidney prescription as TCM group， 15 patients with the same decoction and prednisone as combine group， and 15 patients with prednisone as western medicine group， 4 weeks as one treatment course. After 3 courses， the change of platelet counts， marrow megakaryocyte amount， platelet-produced megakaryocyte proportion and TGF-β1 level in the marrow were observed. Results The fine efficiency of TCM group （55.0%， 11/20） excelled western medicine group （20.0%， 3/15） significantly and close to that of combine group （60.0%， 9/15）. Platelet counts of TCM group was raised obviously after treatment （P 　　Key words：chronic idiopathic thrombocytopenic purpura；expelling wind， cooling blo