参地摄血方加减联合糖皮质激素治疗原发免疫性血小板减少症气血两虚证的临床研究*
作者：肖 红1，周晨晨1，王 琥1，何颖颖1，宋 琴1，孙培养2
单位：1.安徽中医药大学第一附属医院，安徽 合肥 230031； 2.安徽中医药大学第二附属医院，安徽 合肥 230061
引用：引用：肖红，周晨晨，王琥，何颖颖，宋琴，孙培养.参地摄血方加减联合糖皮质激素治疗原发免疫性血小板减少症气血两虚证的临床研究[J].中医药导报,2025,31(9):97-101.
DOI：10.13862/j.cn43-1446/r.2025.09.016
PDF：
下载PDF
摘要：
目的：探讨参地摄血方加减联合糖皮质激素治疗原发免疫性血小板减少症（PIT）气血两虚证的疗效。方法：将72例中医辨证为气血两虚证的PIT患者随机分为对照组（n=36）与治疗组（n=36）。对照组患者采用地塞米松、泼尼松治疗，治疗组患者采用参地摄血方加减联合地塞米松、泼尼松治疗，两组均治疗2个月。检测两组患者治疗前后血小板计数（PLT）、调节性T细胞（Treg）、辅助性T细胞17（Th17），比较两组治疗效果、中医证候积分变化及复发情况。结果：对照组脱落1例，35例完成研究。治疗组36例完成研究。治疗后，两组患者PLT均高于治疗前，且治疗组患者治疗后PLT高于对照组（P＜0.05）。治疗后，两组患者中医证候积分均低于治疗前，且治疗组患者治疗后中医证候积分低于对照组（P＜0.05）。治疗后，两组患者Th17及Th17/Treg水平均低于治疗前，Treg水平均高于治疗前，差异均有统计学意义（P＜0.05）；治疗组患者治疗后Th17、Th17/Treg水平均低于对照组，Treg水平高于对照组，差异均有统计学意义（P＜0.05）。总有效率治疗组为88.89%（32/36），对照组为65.71%（23/35），治疗组总有效率高于对照组（P＜0.05）。随访2个月后，复发率治疗组为3.13%（1/32），对照组为26.09%（6/23），治疗组低于对照组（P＜0.05）。结论：参地摄血方加减联合糖皮质激素治疗PIT气血两虚证有较好疗效，能改善患者中医症状及免疫稳态，降低复发率。
关键词：原发免疫性血小板减少症；气血两虚证；参地摄血方；糖皮质激素；免疫稳态
Abstract：
Objective: To investigate the efficacy of
modified Shendi Shexue Formula combined with glucocorticoids in treating
primary immune thrombocytopenia (PIT) patients with qi and blood deficiency
syndrome. Methods: Seventy-two PIT patients diagnosed with qi and blood deficiency
syndrome were randomly assigned to a control group (n=36) and a treatment group
(n=36). The control group received dexamethasone and prednisone, while the
treatment group received the modified Shendi Shexue Formula plus dexamethasone
and prednisone. The treatment duration for both groups was 2 months. Platelet
count (PLT), regulatory T cells (Treg), and helper T cells 17 (Th17) were
measured before and after treatment. Therapeutic efficacy, changes in
Traditional Chinese Medicine (TCM) syndrome scores, and recurrence rates were
compared between the two groups. Results: One case dropped out in the control
group; 35 cases in the control group and 36 cases in the treatment group
completed the study. After treatment, PLT increased significantly in both groups
compared to baseline (P<0.05), with the treatment group showing a higher PLT
than the control group (P<0.05). TCM syndrome scores decreased significantly
in both groups post-treatment (P<0.05), and the score in the treatment group
was lower than that in the control group (P<0.05). Levels of Th17 and
Th17/Treg decreased, while Treg levels increased significantly in both groups
after treatment (P<0.05). The treatment group exhibited lower Th17 and
Th17/Treg levels and higher Treg levels compared to the control group
(P<0.05). The total effective rate was 88.89% (32/36) in the treatment group
and 65.71% (23/35) in the control group, indicating a significantly higher
efficacy in the treatment group (P<0.05). After a 2-month follow-up, the
recurrence rate was 3.13% (1/32) in the treatment group and 26.09% (6/23) in
the control group, showing a significantly lower recurrence rate in the
treatment group (P<0.05). Conclusion: The combination of modified Shendi
Shexue Formula and glucocorticoids demonstrates good efficacy in treating PIT
with qi and blood deficiency syndrome. It can improve TCM symptoms and immune
homeostasis, and reduce the recurrence rate.
Key words：primary immune thrombocytopenia (PIT); Qi and blood deficiency syndrome; Shendi Shexue Formula; glucocorticoids; immune homeostasis
发布时间：2026-01-08
点击量：39