补肾活髓颗粒联合西药治疗慢性再生障碍性贫血临床疗效的倾向指数研究

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目的应用倾向指数法比较补肾活髓颗粒联合西药治疗与单纯西药治疗慢性再生障碍性贫血的临床疗效。方法选择慢性再生障碍性贫血患者236例,随机分为治疗组158例和对照组78例。对照组给予口服司坦唑醇片每次2~4 mg,每日3次;环孢菌素软胶囊每次75 mg,每日2次。治疗组在对照组治疗基础上给予补肾活髓颗粒,每日1剂,分两次口服。两组均治疗6个月。应用倾向指数匹配法对两组患者基线资料进行匹配,对匹配前后两组临床疗效和匹配后、治疗前后两组患者的血红蛋白(HGB)、白细胞(WBC)及血小板(PLT)水平进行比较。结果两组各有76例成功匹配。匹配前两组临床疗效比较:对照组基本治愈16例,缓解14例,明显进步18例,总有效率61.54%;治疗组分别为50例、36例、34例及75.95%,两组比较差异无统计学意义(χ~2=6.71,P=0.08)。匹配后两组临床疗效比较:对照组基本治愈16例,缓解14例,明显进步17例,总有效率61.84%;治疗组分别为12例、18例、17例及61.84%,两组比较差异无统计学意义(χ~2=1.07,P=0.78)。匹配后两组患者治疗后HGB、WBC及PLT较治疗前均明显升高(P<0.01),治疗组治疗后HGB和PLT均明显高于对照组(P<0.05)。结论补肾活髓颗粒联合西药治疗慢性再生障碍性贫血在改善HGB及PLT方面优于单纯西药。 Objective To compare the clinical effects of Bushen Huoxue Granule combined with western medicine and western medicine in treating chronic aplastic anemia. Methods 236 patients with chronic aplastic anemia were randomly divided into treatment group (158 cases) and control group (78 cases). The control group was given oral stanozolol tablets every 2 ~ 4 mg three times a day; cyclosporin soft capsule 75 mg twice a day. The treatment group was given Bushen Huizui Granules on the basis of the control group, one day and two times orally. Both groups were treated for 6 months. The propensity index matching method was used to match the baseline data of two groups of patients. The levels of hemoglobin (HGB), white blood cells (WBC) and platelet (PLT) were compared between the two groups before and after the curative effect and matching of the two groups before and after the match. Results 76 cases in each group matched successfully. In the control group, 16 cases were cured, 14 cases were relieved, 18 cases were markedly improved, and the total effective rate was 61.54%. The treatment group was 50 cases, 36 cases, 34 cases and 75.95% respectively. There were significant differences between the two groups No statistical significance (χ ~ 2 = 6.71, P = 0.08). In the control group, 16 cases were cured, 14 cases were alleviated, 17 cases improved obviously, the total effective rate was 61.84%. There were 12 cases, 18 cases, 17 cases and 61.84% in the treatment group, respectively. There were significant differences between the two groups No statistical significance (χ ~ 2 = 1.07, P = 0.78). The HGB, WBC and PLT in the two groups after treatment were significantly higher than those before treatment (P <0.01). The HGB and PLT in the treatment group were significantly higher than those in the control group after treatment (P <0.05). Conclusion Bushen Huayu granules combined with Western medicine in treating chronic aplastic anemia is better than pure western medicine in improving HGB and PLT.
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