【摘要】 目的:观察自拟清热凉血组方并TPO联合甲泼尼龙治疗复发难治ITP的临床疗效。方法:选取本院血液科2016年5月至2017年4月收治的60例复发性难治ITP患者,随机分为2组,每组各30例。对照组患者给予重组人血小板生成素注射液(TPO)联合甲泼尼龙治疗,观察组患者在对照组治疗的基础上采用清热凉血方治疗,2组均整体治疗3个月。比较2组患者不同时间段血小板计数(PLT)变化情况,观察2组起效时间、反应持续时间,比较治疗后2组的临床疗效及不良事件发生概率。结果:治疗1周、2周后,2组的PLT水平并没有显著差异(P>0. 05);而治疗1月、2月、3月后,观察组患者的PLT水平明显均较对照组高(P<0. 05);治疗后观察组患者的临床总有效率为86. 7%,对照组患者的临床总有效率为63. 3%,差异显著(P<0. 05);观察组不良事件发生率及总发生频次显著均少于对照组(P<0. 05)。结论:清热凉血方并TPO联合甲泼尼龙可以有效治疗复发难治ITP,并且可以明显降低毒副反应,值得临床推广。更多还原

【Abstract】 Objective: To observe the curative effect of self-made Qingre Liangxue prescription combined with TPO and methylprednisolone in the treatment of recurrent refractory ITP. Methods: Sixty patients with recurrent refractory ITP,who were admitted to the department of Hematology from May 2016 to April 2017,were randomly divided into two groups( 30 cases in each group). The patients in the control group were treated with recombinant human thrombopoietin injection( TPO) combined with methylprednisolone. The patients in the observation group were treated with Qingre Liangxue decoction on the basis of the control group,and both groups were treated for 3 months as a whole. The changes of platelet count( PLT) in two groups were compared.The onset time and the duration of response in two groups were observed. The clinical efficacy and the incidence of adverse events were compared between the two groups. Results: After 1 week and 2 weeks of treatment,there was no significant difference in PLT levels between the two groups( P> 0. 05). After 1 month,2 months and 3 months of treatment,PLT levels in the observation group were significantly higher than those in the control group( P< 0. 05). After treatment,the total clinical effective rate was86. 7% in the observation group and 63. 3% in the control group,with the significant difference( P<0. 05). The incidence and frequency of adverse events in the observation group were significantly less than the control group( P<0. 05). Conclusion: Qingre Liangxue prescription combined with TPO and methylprednisolone can effectively treat ITP with refractory relapse and can significantly reduce the side effects,which deserves clinical promotion.更多还原