清热解毒及活血化瘀中药治疗依赖泼尼松的慢性原发ITP患者的疗效观察

目的观察以清热解毒及活血化瘀中药为主，治疗依赖泼尼松（prednisone,Pred）慢性原发免疫性血小板减少症（chronic primary immune thrombocytopenic purpura,CPITP）患者的疗效。方法用以清热解毒及活血化瘀为主的中药门诊治疗对Pred依赖的CPITP患者，每天一剂，根据血小板数(blood platelet count, BPC)及临床出血情况，逐渐减少Pred的用量。合并中药治疗4周以上者，按中华血液学会提出的疗效标准评价加用中药前后的疗效，并比较加用中药前后BPC和Pred的用量。结果 50例Pred依赖CPITP经中药治疗后，BPC由治疗前的（28.6±22.5）×10⁹ L^-1升至（81.8±56.5）×10⁹ L^-1 (P<0.05); Pred的剂量由中药治疗前的（28.1±15.2） mg/d降到（8.0±9.4） mg/d(P<0.05)；中药治疗前完全反应率、有效率和无效率分别为2%、10%和88%，中药治疗后上述指标分别为30%、46%、24% （ P<0.05）。结论清热解毒及活血化瘀为主中药对依赖Pred的CPITP患者疗效显著，可增强患者对Pred的敏感性和克服对Pred的依赖。

英文摘要:

Objective To observe the clinical efficacy of Qingre Jiedu and Huoxue Huayu Recipe on the prednisone-dependant patients with chronic primary immune thrombocytopenic purpura (CPITP). Methods Fifty prednisone-dependant CPITP patients were treated with Qingre Jiedu and Huoxue Huayu Recipe orally one dose a day, the dosage of prednisone for these patients was tapered according to the monitoring result of blood platelet count (BPC).The therapeutic efficacy in these patients was evaluated before and after Chinese medicine treatment over 4 weeks. Results After the treatment of chinese medicine, BPC was increased from (28.6±22.5) ×10⁹ L^-1 to (81.8±56.5）×10⁹ L^-1 (P<0.05). The dosage of prednisone was decreased from (28.1±15.2) mg/d to (8.0±9.4) mg/d (P<0.05). Complement response, response and no response rate were 2%, 10% and 88% before Chinese medicine treatment, which were 30%,46% and 24% after Chinese medicine treatment, respectively (P＜0.05). Conclusion Qingre Jiedu and Huoxue Huayu Recipe could be effective in the treatment of prednisone-dependant patients with CPITP, and could decrease the dosage of prednisone.

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