滋髓生血胶囊治疗慢性再障临床观察及对骨髓造血组织容量的影响

发布时间：2018-03-07 05:38

本文选题：慢性再障　切入点：滋髓生血胶囊　出处：《河南中医药大学》2016年硕士论文　论文类型：学位论文

【摘要】：目的:通过观察滋髓生血胶囊治疗慢性再生障碍性贫血患者的临床症状、体征、外周血象及骨髓造血组织容量的变化情况,探讨院内制剂滋髓生血胶囊在治疗慢性再生障碍性贫血中的作用机制。方法:1.将2013年12月至2015年10月期间在河南省中医院血液科就诊的60例符合纳入标准的慢性再障患者随机分作为治疗组和对照组,每组各有30例患者组成。治疗组采用滋髓生血胶囊联合环孢素胶囊和司坦唑醇片口服治疗,对照组口服西药环孢素胶囊和司坦唑醇片治疗,每3个月作为一个疗程,共计观察2个疗程后判断疗效。2.两组患者均于治疗前、治疗后由全自动血液分析仪检查外周血血细胞数目;骨髓活检显微镜下观察骨髓造血组织,并比较两组患者治疗前后的症状体征、中医症候、外周血细胞计数和骨髓造血组织容量的变化情况。并对患者治疗前、后分别行心电图、肝肾功能等安全性指标检查。3.对获得数据采用SPSS18.0数据统计分析软件进行处理,对计数资料采用χ2检验,对于计算等级数据资料则采用Ridit分析,经检验服从正态分布后计量资料使用配对样本或独立样本t检验,显著性概率值设为0.05,对于定量统计数据全部采用以(?)±s表示,而对于定性资料采用计算构成比的方法进行分析。结果:1.临床疗效对比结果:治疗组:无效数、明显进步数、缓解数、基本治愈数分别为3、11、13、3,有效率达到90%;对照组分别为8、12、10、0,有效率达到73.33%;使用数据统计软件分析得出:治疗组的有效率明显大于对照组的有效率(P0.05),治疗后治疗组和对照组的有效率相比差异性显著。2.外周血细胞对比分析:治疗组和对照组的红细胞数、白细胞数、血小板数目治疗后均较治疗前显著升高(P0.05),治疗组较对照组外周血细胞数升高显著。3.对骨髓造血组织容量数据对比分析:治疗组的骨髓造血组织容量和对照组相比,在治疗后较治疗前增加更为显著(P0.05),并且治疗后两组间相比治疗组造血组织容量升高程度明显高于对照组。4.中医相关症候疗效对比分析结果:治疗组临床无效、有效、显效、痊愈例数分别为2、9、15、4;对照组分别为7、11、10、2;两组各自总的有效率分别为93.33%、76.67%;治疗组总有效率显著高于对照组(P0.05),有统计学意义,两组中医症候总有效率治疗后差异性明显,在中医相关症候疗效上治疗组和对照组相比,治疗组疗效明显。结论:滋髓生血胶囊联合西药可明显改善慢性再障患者的临床症状,改善外周血象,增加骨髓造血面积,并且效果优于单独使用西药治疗,临床疗效值得肯定;滋髓生血胶囊联合西药对改善患者的中医症候明显优于单纯使用西药治疗;可见滋髓生血胶囊联合西药比单独使用西药治疗能够更显著地改善再障患者外周血象和骨髓造血组织容量及相关中医症候,从而取得了满意的临床效果。
[Abstract]:Objective: to observe the changes of clinical symptoms, signs, peripheral blood images and bone marrow hematopoietic tissue volume in patients with chronic aplastic anemia treated with Ziwei Shengxue capsule. To explore the mechanism of the hospital preparation Zijiu Shengxue capsule in the treatment of chronic aplastic anemia. Methods: 1. 60 cases of chronic aplastic anemia treated in Department of Hematology, Henan Provincial Hospital of traditional Chinese Medicine from December 2013 to October 2015 were included in the study. Patients with aplastic anemia were randomly divided into treatment group and control group. Each group consisted of 30 patients. The treatment group was treated by oral administration of Zimai Shengxue capsule combined with cyclosporine capsule and steazolol tablet, while the control group was treated with western medicine cyclosporine capsule and steazolol tablet every 3 months as a course of treatment. After two courses of treatment, the patients in both groups were examined for the number of peripheral blood cells by automatic blood analyzer before and after treatment, and the bone marrow hematopoietic tissue was observed under bone marrow biopsy microscope. The changes of symptoms and signs, TCM symptoms, peripheral blood cell count and bone marrow hematopoietic tissue volume before and after treatment were compared between the two groups. The safety indexes such as liver and kidney function were examined. The acquired data were processed by SPSS18.0 data statistical analysis software, the count data were analyzed by 蠂 2 test, and the data of calculating grade data were analyzed by Ridit. After normal distribution, the measurement data were tested by paired sample or independent sample t test. The significant probability value was set to 0.05. ) 卤s, and the qualitative data were analyzed using the method of calculating the constituent ratio. Results: 1. Clinical efficacy comparison results: treatment group: invalid number, significant improvement number, remission number, The number of basic cure was 3 1 / 1 / 13 / 3, the effective rate was 90 and the control group was 812 / 10 / 10 and the effective rate was 73.330.Using statistical analysis of data, the results showed that the effective rate of the treatment group was significantly higher than that of the control group (P 0.05), and that of the treatment group and the control group after treatment was significantly higher than that of the control group (P < 0.05). Comparative analysis of peripheral blood cells: the number of red blood cells in the treatment group and the control group, The number of leukocytes and platelets after treatment were significantly higher than those before treatment, and the number of peripheral blood cells in the treatment group was significantly higher than that in the control group. The data of hematopoietic tissue capacity of bone marrow in the treatment group were compared with that in the control group, and the hematopoietic tissue capacity of the treatment group was higher than that of the control group. After treatment, the increase of hematopoietic tissue volume in the treatment group was significantly higher than that in the control group. The results showed that the clinical efficacy of the treatment group was ineffective, effective and effective, and that of the treatment group was significantly higher than that of the control group. The total effective rate of the two groups was 93.33 and 76.67 respectively. The total effective rate of the treatment group was significantly higher than that of the control group (P 0.05), and the difference of the total effective rate of the two groups after the treatment was obvious, and the total effective rate of the treatment group was significantly higher than that of the control group (P 0.05), and the total effective rate of the two groups was significantly higher than that of the control group (P 0.05). Compared with the control group, the therapeutic effect of the treatment group is more obvious than that of the control group. Conclusion: the treatment group can obviously improve the clinical symptoms, improve the peripheral blood picture and increase the bone marrow hematopoiesis area of the patients with chronic aplastic anemia. And the effect is better than using western medicine alone, the clinical curative effect is worthy of affirmation, the combination of Zijiu Shengxue capsule and western medicine is obviously superior to the simple use of western medicine to improve the symptoms of traditional Chinese medicine. It can be seen that the combination of Ziwei Shengxue capsule and western medicine can significantly improve the peripheral blood picture bone marrow hematopoietic tissue volume and related TCM symptoms of patients with aplastic anemia compared with the treatment of western medicine alone. Thus satisfactory clinical results have been obtained.
【学位授予单位】：河南中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R259

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