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目的:观察健脾滋肾泻火中药联合小剂量泼尼松治疗慢性血小板减少症的临床疗效,并探究其作用机理。方法:将60例符合纳入标准患者随机分为治疗组和对照组(各30例),治疗组采用健脾滋肾泻火中药联合小剂量激素治疗,对照组采用标准糖皮质激素(泼尼松)治疗;两组疗程均为3个月,观察临床疗效及血小板计数及外周血Treg细胞等指标的变化情况。结果:治疗组和对照组总效率分别为90.00%和46.67%,组间临床疗效比较,差异具有统计学意义(P<0.05)。治疗前治疗组、对照组和正常组三组之间血小板计数和外周血Treg细胞相互比较,治疗组和对照组之间无差异,治疗组、对照组和正常组之间有差异,差异有统计学意义(P<0.05)。治疗组和对照组ITP外周血Treg细胞低表达治疗后显著上升(P<0.05)。治疗后治疗组和对照组组间比较,上述指标差异均具有统计学意义(P<0.05)。结论:健脾滋肾泻火中药治疗ITP疗效明显优于单纯ITP治疗,可以提升抑制免疫细胞的计数,维持体内外周血免疫稳态,从而达到减少血小板破坏的目的。
Objective: To observe the clinical efficacy of Jianpi Zishenhuo combined with low-dose prednisone in the treatment of chronic thrombocytopenia and explore its mechanism. Methods: Sixty patients with inclusion criteria were randomly divided into treatment group (n = 30) and control group (n = 30). The treatment group was treated with Jianpizhen Renzhonghuo combined with small dose of hormone therapy, while the control group was treated with standard glucocorticoid ) Treatment; two courses of treatment were 3 months, observe the clinical efficacy and platelet count and peripheral blood Treg cells and other indicators of change. Results: The total efficiency of the treatment group and the control group was 90.00% and 46.67%, respectively. There was significant difference between the two groups in clinical efficacy (P <0.05). There was no difference between the treatment group and the control group in the treatment group, the control group and the normal group, and there was difference between the treatment group, the control group and the normal group Significance (P <0.05). The expression of Treg cells in ITP peripheral blood in treatment group and control group was significantly increased after treatment (P <0.05). After treatment, the differences between the above two groups were statistically significant (P <0.05). Conclusion: The therapeutic effect of Jianpizhen Renxuetong Chinese medicine on ITP is better than that of ITP alone. It can enhance the inhibition of immune cell count and the maintenance of immune homeostasis in peripheral blood so as to reduce the destruction of platelets.