摘要
目的:观察六味地黄汤加减对血液透析肝肾阴虚型血小板减少症患者疲劳状况、免疫调节的影响。方法:选择2020年2月至2022年2月该院诊治的血液透析肝肾阴虚型血小板减少症患者200例,以随机数字表法分为治疗组和对照组。治疗组100例患者给予常规西医联合六味地黄汤加减治疗,对照组100例患者给予常规西医治疗。治疗前后检测两组患者的T淋巴细胞CD4^(+)、CD8^(+),B淋巴细胞CD19^(+),调节性B细胞(Breg),血小板膜糖蛋白CD41、CD61,转化生长因子-β1(TGF-β1)、白细胞介素10(IL-10)、干扰素-γ(IFN-γ)、血小板生成素(TPO)和血小板计数(PLT)等指标水平,并计算血小板压积(PCT),测定疲劳评定量表(FAI)评分和中医证候评分,比较两组患者的临床疗效、不良反应发生率。结果:治疗后,治疗组患者的Breg、CD4^(+)水平高于对照组,CD19^(+)、CD8^(+)水平低于对照组,差异均有统计学意义(P<0.05)。治疗后,治疗组患者的IFN-γ、TGF-β1水平低于对照组,IL-10水平高于对照组,差异均有统计学意义(P<0.05)。治疗后,治疗组患者的PLT、PCT水平高于对照组,TPO水平低于对照组,差异均有统计学意义(P<0.05)。治疗后,治疗组患者的血小板膜糖蛋白CD41、CD61水平高于对照组,差异有统计学意义(P<0.05)。治疗后,治疗组患者的FAI评分,中医证候主症、次症评分较对照组降低,差异均有统计学意义(P<0.05)。治疗组患者的总有效率为97.00%(97/100),高于对照组(84.00%,84/100),差异有统计学意义(P<0.05)。两组患者不良反应发生率的差异无统计学意义(P>0.05)。结论:六味地黄汤加减治疗血液透析肝肾阴虚型血小板减少症患者,可提高Breg、CD4^(+)水平,降低CD19^(+)、CD8^(+)水平,调节机体免疫,抑制机体TGF-β1水平,促进Th1/Th2细胞保持动态平衡,抑制机体炎症,改善血小板水平,缓解患者疲劳状况及临床症状,提高临床疗效。
OBJECTIVE:To observe the effects of modified Liuwei Dihuang decoction on fatigue and immune regulation of patients with thrombocytopenia of liver and kidney Yin deficiency type in hemodialysis.METHODS:A total of 200 cases of thrombocytopenia of liver and kidney Yin deficiency type in hemodialysis treated in the hospital from Feb.2020 to Feb.2022 were divided into the treatment group and control group via the random number table method.The treatment group(n=100)received conventional western medicine combined with modified Liuwei Dihuang decoction,while the control group(n=100)received conventional western medicine.CD4^(+)and CD8^(+)of T lymphocytes and CD19^(+)of B lymphocytes,regulatory B cells(Breg),CD41 and CD61 of platelet membrane glycoproteins,transforming growth factor-β1(TGF-β1),interleukin-10(IL-10),interferon-γ(IFN-γ),thrombopoietin(TPO)and platelet count(PLT)before and after treatment were detected.Platelet accumulation(PCT)level was calculated,fatigue assessment instrument(FAI)score and traditional Chinese medicine syndrome score were measured.The clinical efficacy and incidence of adverse drug reactions were compared between two groups.RESULTS:After treatment,the levels of Breg and CD4^(+)in the treatment group were higher than those in the control group,while the levels of CD19^(+)and CD8^(+)were lower than those in the control group,with statistically significant differences(P<0.05).After treatment,the levels of IFN-γand TGF-β1 in the treatment group were lower than those in the control group,and the levels of IL-10 were higher than those in the control group,with statistically significant difference(P<0.05).After treatment,the levels of PLT and PCT in the treatment group were higher than those in the control group,and the levels of TPO were lower than those in the control group,with statistically significant differences(P<0.05).After treatment,the levels of CD41 and CD61 of platelet membrane glycoproteins in the treatment group were higher than those in the control group,the difference was st
作者
曹蓉
魏华娟
孙珊珊
秦娜
刘伟花
李叶
CAO Rong;WEI Huajuan;SUN Shanshan;QIN Na;LIU Weihua;LI Ye(Dept.of Nephrology,Shijiazhuang Hospital of Traditional Chinese Medicine,Shijiazhuang 050000,China)
出处
《中国医院用药评价与分析》
2023年第8期940-944,共5页
Evaluation and Analysis of Drug-use in Hospitals of China
基金
河北省中医药管理局中医药科研计划项目(No.2019429)。
关键词
六味地黄汤加减
血液透析
肝肾阴虚型血小板减少症
免疫调节
TH1/TH2平衡
疲劳状况
Modified Liuwei Dihuang decoction
Hemodialysis
Thrombocytopenia of liver and kidney Yin deficiency type
Immune regulation
Th1/Th2 balance
Fatigue status
