摘要
目的通过观察紫癜合剂对原发性免疫性血小板减少症(ITP)血热型患者细胞因子的影响,探讨有效中药复方制剂对ITP血热型患者免疫紊乱调控的有效干预机制。方法将符合要求的60例血热型ITP患者随机分为中药组和激素组,每组各30例。中药组患者给予紫癜合剂口服治疗,激素组患者给予强的松口服治疗,疗程均为3个月。比较两组患者的临床疗效及中医证候积分,检测两组患者的血清细胞因子白介素(IL)-11、IL-6、IL-10、血小板生成素(TPO)、转化生长因子(TGF)-β1的表达水平。结果治疗后,中药组的临床总有效率为93.33%,激素组为83.33%;两组临床疗效比较,差异无统计学意义(P>0.05)。治疗后,两组患者的中医证候积分较治疗前均明显降低(P<0.05),且中药组患者的中医证候积分低于激素组(P<0.05)。治疗后,中药组患者的TPO、IL-10、TGF-β1表达较治疗前均明显升高(P<0.05),IL-11、IL-6表达较治疗前明显降低(P<0.05);激素组患者的TPO、IL-10表达较治疗前亦明显升高(P<0.05),IL-11表达较治疗前明显降低(P<0.05);且中药组患者的TGF-β1表达明显高于激素组(P<0.05),IL-6表达明显低于激素组(P<0.05)。结论紫癜合剂可有效改善ITP血热型患者的中医证候,上调患者的TPO、IL-10、TGF-β1水平,降低IL-6、IL-11水平,从而改善患者的免疫功能紊乱状态,这可能是中医"清热、凉血、宁络"治疗ITP血热型患者的主要途径之一。
Objective To observe the effects of purpura mixture on cytokines in patients of primary immune thrombocytopenia( ITP) with syndrome of blood-heat,and discuss the regulation mechanism of compound preparation of Chinese medicine on immunologic derangement in ITP patients with syndrome of blood-heat.Methods 60 ITP patients with syndrome of blood-heat were randomly divided into Chinese medicine group and hormone group,30 cases in each group. The Chinese medicine group was orally treated with purpura mixture,and the hormone group was orally treated with prednisone,with a course of 3 months. The clinical efficacy and TCM syndrome score in both groups were compared,the serum levels of IL-11,TPO,IL-6,IL-10 and TGF-β1 were detected. Results After treatment,the clinical total effective rates were 93.33% in the Chinese medicine group and 83.33% in the hormone group,with no statistically significant difference( P>0.05).After treatment,the TCM syndrome score was obviously decreased in both groups( P<0.05),and the TCM syndrome score of the Chinese medicine group was lower than that of the hormone group( P<0.05). After treatment,the levels of TPO,IL-10 and TGF-β1 were increased in Chinese medicine group( P < 0.05),and the levels of IL-11 and IL-6 were decreased( P<0.05). The levels of TPO and IL-10 were increased in hormone group( P<0.05),and the level of IL-11 was decreased( P<0.05). The TGF-β1 level in the Chinese medicine group was significantly higher than that in the hormone group( P<0.05),and the IL-6 level in the Chinese medicine group was lower than that in the hormone group( P<0.05). Conclusion The purpura mixture can effectively improve the clinical TCM syndrome of ITP patients with syndrome of blood-heat,up-regulate the levels of TPO,IL-10 and TGF-β1,reduce the levels of IL-6 and IL-11,and thus improve the immune function disorder,which may be one of the main ways of TCM therapy of " clearing heat and cooling blood and dredging collaterals" in treating ITP patients with syndrome of blood-heat.
出处
《上海中医药杂志》
2017年第S1期90-92,97,共4页
Shanghai Journal of Traditional Chinese Medicine
基金
上海市卫计委中医药科研专项课题(2016LP045)
关键词
紫癜合剂
免疫性血小板减少症
血热型
细胞因子
purpura mixture
immune thrombocytopenia
syndrome of blood-heat
cytokines
