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目的:探讨中西医结合治疗难治性血小板减少症(r ITP)的临床效果。方法:将35例r ITP患者,随机分成两组,分别采用单纯西药(强的松、长春地辛)和中西医结合(强的松、益气养血活血方)进行治疗,6个月后观察治疗效果,对比分析患者外周血和骨髓相关指标的变化。结果:中西医结合治疗r ITP的总有效率和完全反应率均明显高于单纯西医治疗(P<0.05)。患者血小板的指标中,治疗后中西医结合组血小板计数(PLT),血小板压积(PCT)升高水平均高于单纯西医治疗组(P<0.01),而血小板平均体积(MPV),血小板体积分布宽度(PDW)下降水平均低于单纯西医治疗组(P<0.01)。中西医结合治疗组患者血小板抗体相关免疫球蛋白G(PAIg G)升高水平明显大于单纯西医治疗组(P<0.01)。中西医结合治疗组患者骨髓中巨核细胞升高水平明显大于单纯西医治疗组(P<0.05),颗粒巨核细胞与裸核巨核细胞治疗后较治疗前明显减少。结论:中西医结合(强的松、益气养血活血方)对r ITP具有较好的疗效。
Objective: To explore the clinical effect of integrated traditional Chinese and western medicine in the treatment of refractory thrombocytopenia (r ITP). Methods: Thirty-five patients with r ITP were randomly divided into two groups. The patients were treated with pure western medicine (prednisone and vindesine) and traditional Chinese and western medicine (prednisone and qi and nourishing blood and promoting blood circulation) respectively. After 6 months Observed the treatment effect, comparative analysis of patients with peripheral blood and bone marrow-related indicators of change. Results: The total effective rate and complete response rate of Integrative Medicine r ITP were significantly higher than that of western medicine (P <0.05). In patients with platelet index, the levels of platelet count (PLT) and platelet pressure (PCT) in Integrative Medicine group after treatment were all significantly higher than those in Western medicine group (P <0.01), while mean platelet volume (MPV), platelet volume The decrease of PDW was lower than that of western medicine group (P <0.01). The level of platelet antibody - associated immunoglobulin G (PAIgG) in patients receiving traditional Chinese and Western medicine was significantly higher than that of western medicine group (P <0.01). Compared with western medicine group (P <0.05), the level of megakaryocyte in the bone marrow of patients receiving traditional Chinese and western medicine combination therapy was significantly higher than that of the western medicine group (P <0.05). Granulocytes and naked megakaryocytes were significantly decreased after treatment. Conclusion: The combination of traditional Chinese and western medicine (prednisone, qi nourishing and invigorating blood circulation) has better curative effect on r ITP.