补肾生髓方治疗非重型再生障碍性贫血（肾阴虚型）短期疗效观察

发布时间：2018-03-28 09:16

本文选题：非重型再生障碍性贫血　切入点：补肾生髓方　出处：《山西医科大学》2017年硕士论文

【摘要】：目的:本文旨在观察补肾生髓方联合环孢素软胶囊和十一酸睾酮软胶囊治疗非重型再生障碍性贫血(肾阴虚型)短期临床疗效,以期判定补肾生髓方联合西药治疗非重型再生障碍性贫血是否确有增效减毒作用。方法:采用随机对照的试验方法,将41例患者(符合非重型再生障碍性贫血的西医诊断标准、肾阴虚型的中医证候诊断标准,并且同时符合纳入和排除标准),随机分为两组,治疗组21例,对照组20例。治疗组给予环孢素软胶囊,3-6mg/Kg,Q12h;十一酸睾酮软胶囊,40mg,3次/日;补肾生髓方150ml,2次/日,空腹温服。对照组给予环孢素软胶囊,3-6mg/Kg,Q12h;十一酸睾酮软胶囊,40mg,3次/日。两组疗程均为6个月。试验过程中均不可用与补肾生髓方作用相近甚至相同的中草药、中成药等。观察两组患者治疗前后外周血细胞计数[白细胞(WBC)、血红蛋白(HB)、血小板(PLT)、网织红细胞(RET)]、中医证候(临床症状)变化情况及不良反应。结果:疗效性评价:(1)疗效性:治疗组总有效率(缓解+明显进步)为85.7%,对照组总有效率60.0%。二者之间存在显著性差异(P0.05)。(2)外周血象比较(WBC、HB、PLT、RET计数):两组患者外周血WBC、HB、PLT、RET计数在治疗前和治疗后均存在显著性差异(P0.05),可认为单用西药组和中西药联合治疗组对NSAA患者外周血WBC、HB、PLT、RET升高均有效,但四项指标升高的程度却有所不同:两组治疗前和治疗后相对比,外周血HB和RET计数存在显著性差异(P0.05),然而WBC和PLT数上升无显著性差异(P0.05),即补肾生髓方联合西药治疗NSAA主要对患者外周血红系升高比较理想。(3)中医证候:中西药物治疗组总有效率为85.7%,对照组总有效率为65.0%,两组中医证候对比差异有统计学意义(P0.05),可认为补肾生髓方联合西药治疗组比单用西药对照组更能明显改善患者中医证候(临床症状)。不良反应比较:治疗组可以减少西药所造成的不良反应。结论:1.中药联合西药组和单用西药组均可升高非重型再障(肾阴虚型)患者外周血WBC、HB、PLT、RET计数。2.中药联合西药组在升高非重型再障(肾阴虚型)患者外周血HB、RET方面比单用西药组疗效好。3.中药联合西药可明显改善患者临床症状(主要是中医证候)。4.中药联合西药可以减少不良反应。本课题为山西医科大学第二医院院内新技术新项目“补肾生髓方治疗非重型再生障碍性贫血临床观察(编号:201621)”。
[Abstract]:Objective: to observe the short-term clinical effect of Bushen Shengmai recipe combined with Cyclosporin soft capsule and testosterone undecanoate soft capsule in the treatment of non-severe aplastic anemia (kidney-yin deficiency type). The purpose of this study was to determine whether the combination of Bushenshengmai recipe and western medicine in the treatment of non-severe aplastic anemia has synergistic and detoxifying effects. Methods: a randomized controlled trial was conducted in 41 patients (in accordance with the diagnostic criteria of Western medicine for non-severe aplastic anemia). The traditional Chinese medicine syndrome diagnosis criteria of kidney yin deficiency type were randomly divided into two groups: treatment group (n = 21) and control group (n = 20). The treatment group was given cyclosporine soft capsule 3-6 mg / kg Q12h, testosterone undecanoate soft capsule 40 mg / d; Bushen Shengmai recipe 150 ml / d, The control group was given Ciclosporin soft capsule 3-6 mg / kg Q12 h and testosterone undecanoate 40 mg / day for 3 times a day. The course of treatment in both groups was 6 months. In the course of the experiment, no Chinese herbal medicine with similar or even the same effect as Bushen Shengmai recipe could be used. Observe the changes of peripheral blood cell count before and after treatment [WBC WBCU, hemoglobin HBN, PLT, reticulocyte reticulocyte (RET)], TCM syndromes (clinical symptoms) and adverse reactions. Results: curative effect evaluation. (1) Therapeutic effect: the total effective rate in the treatment group was 85.7and the total effective rate in the control group was 60.0.There was a significant difference between the two groups (P < 0.05). There were significant differences between the two groups after treatment (P 0.05). It can be concluded that both the western medicine group and the Chinese and western medicine combined treatment group are effective in increasing the level of NSAA in peripheral blood. But the levels of the four markers were different: the two groups were compared before and after treatment. There is a significant difference between HB and RET counts in peripheral blood. However, there is no significant difference in the number of WBC and PLT between them. That is to say, the combination of Bushenshengmai recipe and western medicine is more ideal for the increase of peripheral blood erythroid in patients.) TCM syndromes: Chinese and Western medicine: Chinese and western medicine. The total effective rate of the treatment group was 85.7 and the total effective rate of the control group was 65.0. The difference of TCM syndromes between the two groups was statistically significant (P 0.05). It can be concluded that the treatment group with Bushenshengmai decoction combined with western medicine can obviously improve the TCM syndrome of the patients compared with the control group of western medicine alone. (comparison of clinical symptoms and adverse reactions: the treatment group can reduce the adverse reactions caused by western medicine. Conclusion: 1. Both Chinese medicine combined with western medicine group and western medicine group can increase the peripheral blood WBCCU HBG PLTRET count in patients with non-severe aplastic anemia (kidney yin deficiency type). The therapeutic effect of traditional Chinese medicine combined with western medicine group in increasing the peripheral blood HBs RET of patients with non-severe aplastic anemia (kidney yin deficiency type) is better than that of western medicine alone. 3. The combination of traditional Chinese medicine and western medicine can obviously improve the clinical symptoms of patients (mainly TCM syndromes. 4. Traditional Chinese medicine combined with traditional Chinese medicine). Western medicine can reduce adverse reactions. This project is a new technique and new item in the hospital of the second Hospital of Shanxi Medical University, "Clinical observation of tonifying kidney and generating marrow prescription in treating non-severe aplastic anemia (no.: 201621)".
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R556.5

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