两地升血汤治疗慢性再生障碍性贫血肾元亏损证的临床疗效观察

发布时间：2018-03-17 19:45

  本文选题：两地升血汤　切入点：慢性再生障碍性贫血　出处：《湖南中医药大学》2016年硕士论文　论文类型：学位论文

【摘要】：目的:观察两地升血汤对慢性再生障碍性贫血(CAA)患者临床症状、中医症候、血象、网织红细胞计数、外周血淋巴细胞亚群比例、骨髓象的影响,评价其治疗慢性再生障碍性贫血的疗效和安全性,揭示出两地升血汤治疗CAA的优势,为临床应用及实验研究提供依据,为中医药治疗慢性再生障碍性贫血做出贡献。方法:将60例慢性再生障碍性贫血(CAA)患者随机分为中药方剂组和西药对照组,中药方剂组30例,西药对照组30例,中药方剂组采用两地升血汤中药煎剂治疗;西药对照组采用环孢素A、安雄口服治疗,治疗疗程两组都为6个月。观察临床疗效,并检测两组患者治疗前后血象、网织红细胞计数、外周血淋巴细胞亚群比例、骨髓象水平。结果:中药方剂组西医临床总有效率为86.7%,西药对照组总有效率为80.0%,两组均可以有效的提高慢性再生障碍性贫血患者的血象,经统计无显著性差异(P0.05)。对中药方剂组与西药对照组改善中医症候疗效进行比较,中药方剂组总有效率90.0%,西药对照组总有效率为53.3%,经检验两组差异有统计学意义(P0.05),表明中药方剂组在改善患者中医临床症状方面明显优于西药对照组;且中药方剂组与西药对照组均可提升CAA患者血象,且中药方剂组较西药对照组效果更明显。并可有效调节CAA患者T淋巴细胞亚群CD4+、CD8+水平,且效果相当。治疗后,对两组骨髓有核红细胞比例、中性粒细胞比例、淋巴细胞比例、巨核细胞计数进行组间比较,经检验,除巨核细胞比较差异无统计学意义,余各项比较差异有统计学意义。提示中药方剂组与西药对照组均可促进再障患者骨髓造血,且中药方剂组较西药对照组效果更明显。中药方剂组治疗安全性较好,无明显毒副作用,不良反应发生率低。结论:1.两地升血汤治疗CAA有确切疗效。2.两地升血汤可以有效提升患者外周血象及网织红细胞计数、促进骨髓造血,有效调节CAA患者T淋巴细胞亚群CD4+、CD8+,其具体作用机制有待于进一步探讨研究。3.两地升血汤治疗CAA安全可靠,无明显毒副作用,不良反应发生率低。
[Abstract]:Objective: to observe the effects of Shengxue decoction on the clinical symptoms, traditional Chinese medicine symptoms, hemogram, reticulocyte count, lymphocyte subsets in peripheral blood and bone marrow in patients with chronic aplastic anemia (CAA). To evaluate its efficacy and safety in the treatment of chronic aplastic anemia, to reveal the advantages of Shengxue decoction in treating CAA, and to provide the basis for clinical application and experimental study. Methods: 60 patients with chronic aplastic anemia were randomly divided into traditional Chinese medicine (TCM) group and western medicine control group (n = 30) and control group (n = 30). The traditional Chinese medicine prescription group was treated with traditional Chinese medicine decoction of both places of Shengxue decoction, and the western medicine control group was treated with cyclosporine A and Anxiong orally for 6 months. The clinical curative effect was observed and the blood picture of the two groups was detected before and after treatment. Reticulocyte count, lymphocyte subsets in peripheral blood, Results: the total effective rate of western medicine was 86.7 in the traditional Chinese medicine prescription group, and the total effective rate in the western medicine control group was 80.0. Both groups could effectively improve the blood picture of the patients with chronic aplastic anemia. There was no significant difference in statistics (P 0.05). The effects of traditional Chinese medicine prescription group and western medicine control group on improving TCM symptoms were compared. The total effective rate of traditional Chinese medicine prescription group was 90.0 and that of western medicine control group was 53.3.The difference between the two groups was statistically significant (P 0.05), which indicated that the traditional Chinese medicine prescription group was obviously superior to the western medicine control group in improving the clinical symptoms of Chinese medicine. The Chinese medicine prescription group and the western medicine control group could enhance the blood picture of CAA patients, and the effect of traditional Chinese medicine prescription group was more obvious than that of western medicine control group, and it could effectively regulate the level of CD4 CD8 in T lymphocyte subsets of CAA patients, and the effect was similar after treatment. The ratio of nucleated erythrocytes, neutrophils, lymphocytes and megakaryocytes in bone marrow were compared between the two groups. The results showed that there was no significant difference between the two groups except megakaryocytes. It was suggested that both the Chinese medicine prescription group and the western medicine control group could promote hematopoiesis in the bone marrow of the patients with aplastic anemia, and the effect of the traditional Chinese medicine prescription group was more obvious than that of the western medicine control group. There were no obvious side effects, and the incidence of adverse reactions was low. Conclusion (1) Liangshengxue decoction is effective in the treatment of CAA. 2. Shengxue decoction can effectively promote peripheral blood count and reticulocyte count, and promote bone marrow hematopoiesis. The specific mechanism of regulating T lymphocyte subsets (CD4 / CD8) in patients with CAA needs to be further studied. 3. It is safe and reliable to treat CAA with Shengxue decoction and has no obvious side effects, and the incidence of adverse reactions is low.
【学位授予单位】：湖南中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R259

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