祛风法对凉血补肾中药治疗慢性特发性血小板减少性紫癜疗效影响.docVIP

祛风法对凉血补肾中药治疗慢性特发性血小板减少性紫癜疗效影响 　 作者：戴媺，陈志雄，于天启，杨宏光，陈亚勇 【摘要】 　　【目的】观察祛风法对凉血补肾中药治疗慢性特发性血小板减少性紫癜（ＣＩＴＰ）的疗效及其对免疫调节功能的影响。【方法】将４２例ＣＩＴＰ患者随机分为两组，治疗组２２例，予祛风凉血补肾法治疗；对照组２０例，予凉血补肾法治疗。两组均以６周为１个疗程，连续治疗３个疗程。观察两组临床疗效及治疗前后血清白介素２（ＩＬ２）、可溶性白介素２受体（sＩＬ２Ｒ）、Fas蛋白、FasＬ蛋白、血小板相关抗体（PAIgG）和淋巴细胞亚群等免疫学指标的变化。【结果】治疗组治愈１４例，显效５例，有效２例，无效１例，总有效率为９５５％；对照组治愈８例，显效４例，有效３例，无效５例，总有效率为７５０％；两组比较治疗组疗效优于对照组（Ｐ＜００５）。治疗后两组的血清ＩＬ２水平较治疗前显著性提高，sIL2R水平则显著性下降（与治疗前比较，Ｐ＜００１），且治疗组提高ＩＬ２、降低sIL2R的作用更明显（与对照组比较，Ｐ＜００５）。治疗后两组血小板Fas蛋白和FasL蛋白表达及PAIgG水平均下调（与治疗前比较，Ｐ＜００１），且治疗组的下调作用更明显（与对照组比较，Ｐ＜００５）。治疗后两组患者ＣＤ+４Ｔ细胞百分率、ＣＤ+４／ＣＤ+８比值均明显提高，ＣＤ+８Ｔ细胞百分率明显降低（与治疗前比较，Ｐ＜００５）。【结论】加用祛风药能提高凉血补肾中药治疗慢性特发性血小板减少性紫癜的疗效。 【关键词】 紫癜，血小板减少性／中药疗法；祛风；凉血；补肾 　　Abstract： Objective To observe the influence of winddispelling therapy on therapeutic effect of bloodcooling and kidneytonifying herbs for chronic idiopathic thrombocytopenic purpura (CITP),and to investigate its immunoregulatory effect.MethodsFortytwo CITP patients were randomized into 2 groups:the treatment group (N=22) received therapy of dispelling wind,cooling blood and tonifying kidney,and the control group (N=20) received therapy of cooling blood and tonifying kidney.Six weeks constituted one treatment course,and the treatment lasted 3 courses.Serum interleukin 2 (IL2),soluble IL2 receptor (sIL2R),Fas protein,FasL protein,and plateletassociated immunoglobulin G (PAIgG) levels and lymphocyte subtypes were compared before and after treatment.ResultsIn the treatment group,14 patients were clinically cured,5 markedly effective,2 effective,1 ineffective and the total effective rate was 955%;in the control group,8 patients were clinically cured,4 markedly effective,3 effective,5 ineffective and the total effective rate was 750%.The therapeutic effect in the treatment group was superior to that in the control group (P＜005).Serum IL2 level was increased,and sIL2R decreased in the two groups after treatment (P＜001 compared with those before treatment),and the above changes were ob