CAJ | 학술논문

目的：观察白芍总苷联合中药辨证治疗老年慢性原发免疫性血小板减少症的疗效。方法：63例老年原发免疫性血小板减少症患者随机分为对照组（30例）及治疗组（33例），对照组应用基础常规治疗及中药辨证施治，治疗组在对照组基础上联合白芍总苷胶囊600 mg，3次／d，口服，疗程均为3个月，观察2组患者临床疗效，治疗前后血小板、出血症状改善及起效时间比较。结果：1）治疗组总有效率81．81％，对照组总有效率60．00％。2组间比较均有统计学意义（P ＜0．05）；2）治疗组在提高血小板水平、改善出血症状及起效时间方面均优于对照组（P ＜0．05）；3）治疗组中3个不同证型患者疗效比较，气虚失摄型、血热妄行型优于阴虚火旺型（P ＜0．05）；4）有8例患者在治疗起始阶段出现腹泻症状，经对症处理后腹泻即止。肝功能、肾功能，电解质等生化指标与心电图及胸部 X 线片在患者治疗后复查均无异常，无加重甚至减轻原有并发症。结论：白芍总苷联合中辨证治疗老年慢性原发免疫性血小板减少症提高外周血小板水平，起效时间短，改善出血症状，不良反应小，尤适用于气血不摄型、血热妄行型，具有较好的治疗效果。
목적：관찰백작총감연합중약변증치료노년만성원발면역성혈소판감소증적료효。방법：63례노년원발면역성혈소판감소증환자수궤분위대조조（30례）급치료조（33례），대조조응용기출상규치료급중약변증시치，치료조재대조조기출상연합백작총감효낭600 mg，3차／d，구복，료정균위3개월，관찰2조환자림상료효，치료전후혈소판、출혈증상개선급기효시간비교。결과：1）치료조총유효솔81．81％，대조조총유효솔60．00％。2조간비교균유통계학의의（P ＜0．05）；2）치료조재제고혈소판수평、개선출혈증상급기효시간방면균우우대조조（P ＜0．05）；3）치료조중3개불동증형환자료효비교，기허실섭형、혈열망행형우우음허화왕형（P ＜0．05）；4）유8례환자재치료기시계단출현복사증상，경대증처리후복사즉지。간공능、신공능，전해질등생화지표여심전도급흉부 X 선편재환자치료후복사균무이상，무가중심지감경원유병발증。결론：백작총감연합중변증치료노년만성원발면역성혈소판감소증제고외주혈소판수평，기효시간단，개선출혈증상，불량반응소，우괄용우기혈불섭형、혈열망행형，구유교호적치료효과。
Objective:To observe the effect of Total Glucosides of Peony (TGP)combined with Chinese medicine on elderly pa-tients with Chronic Idiopathic Thrombocytopenic Purpura (CITP).Methods:Old patients with CITP of 63 cases were randomly divided into two groups:control group (33 cases),treatment group (33 cases).The control group was given traditional treatment combined with Chinese medicine syndrome differentiation while the treatment group was given oral TGP (600 mg per time,3 times per day)adding to the treatment of the control group.The therapeutic course was 3 months for the two groups.The platelet count level,the bleeding sites were observed before and after treatment as well as the clinical efficacy.Results:Firstly,the total effec-tive rate of treatment group was 81.81% and 60.00% of control group,showing significant difference (P <0.05).Secondly,the platelet level,bleeding site,and effective time of the treatment group were all better than those of the control group with significant diffidence(P <0.05).Thirdly,the total effective rate showed significant diffierence within three syndromes in the treatment group (P <0.05),syndrome of qi failing to control blood and renetic stirring of blood heat had better improvement than syndrome of yin deficiency and effulgent fire.Fourthly,there were eight patients having symptoms of diarrhea at the beginning of the treatment but recovered after treatment.Related indexes in western medicine showed no abnormalities.Original complications didn’t aggravate but even recovered.Conclusion:TGP combined with Chinese medicine can improve the level of peripheral blood platelet,shorten the onset time and effectively control bleeding symptoms with little adverse effect,especially for the syndrome of qi failing to control blood and renetic stirring of blood heat.