槐杞黄颗粒治疗原发免疫性血...17和CD4_CD8的影响_岳迎宾.pdf

现代生物医学进展Progress in Modern Biomedicine Vol.23NO.1JAN.2023doi:10.13241/ki.pmb.2023.01.014槐杞黄颗粒治疗原发免疫性血小板减少症患儿疗效及对血小板参数、外周血 Treg/Th17 和 CD4/CD8 的影响*岳迎宾刘玉李丹露李明伟严媚（新疆医科大学第一附属医院儿内一科 新疆 乌鲁木齐 830054）摘要 目的：探讨槐杞黄颗粒治疗原发免疫性血小板减少症（ITP）患儿疗效及对血小板参数、外周血 Treg/Th17 和 CD4/CD8 的影响。方法：2019 年 8 月到 2021 年 5 月选择在本院诊治的免疫性血小板减少症患儿 60 例作为研究对象，根据 1:1 简单分配原则把患儿分为槐杞黄颗粒组与对照组各 30 例。对照组给予常规药物-注射用人免疫球蛋白治疗，槐杞黄颗粒组以对照组为基础，给予槐杞黄颗粒治疗，两组都治疗观察 3 个月，观察患儿治疗疗效与血小板参数、外周血 Treg/Th17 和 CD4/CD8 的变化情况。结果：治疗后槐杞黄颗粒组的总有效率为 96.7%，明显高于对照组的 80.0%（P0.05）。槐杞黄颗粒组的起效时间少于对照组，疗效维持时间多于对照组，两两对比有明显差异（P0.05）。两组治疗后的血小板计数、血小板参数都明显高于治疗前，槐杞黄颗粒组也明显高于对照组（P0.05）。两组治疗后的外周血 Treg/Th17 和 CD4/CD8 比值都明显高于治疗前，槐杞黄颗粒组明显高于对照组（P0.05）。结论：槐杞黄颗粒治疗原发免疫性血小板减少症患儿能有效提高治疗效果，可缩短起效时间，延长疗效持续时间，还能有效改善患儿的血小板计数、血小板参数，提高外周血 Treg/Th17 和 CD4/CD8 水平。关键词：槐杞黄颗粒；原发免疫性血小板减少症；血小板参数；Treg/Th17；CD4/CD8中图分类号：R558.2文献标识码：A文章编号：1673-6273（2023）01-73-04Curative Effect of Huaiqihuang Granule in The Treatment of Children withPrimary Immune Thrombocytopenia and Its Effect on Platelet Parameters,Peripheral Blood Treg/Th17 and CD4/CD8*YUE Ying-bin,LIU Yu,LI Dan-lu,LI Ming-wei,YAN Mei(Pediatric internal medicine department 1,The First Affiliated Hospital of Xinjiang Medical University,Urumqi,Xinjiang,830054,China)ABSTRACT Objective:To investigate the efficacy of Huaiqihuang granule in the treatment of children with idiopathicthrombocytopenic purpura(ITP)and its effect on platelet parameters,peripheral blood Treg/Th17 and CD4/CD8.Methods:From August2019 to May 2021,60 children with immune thrombocytopenia treated in our hospital were selected as research subjects.Children weredivided into Huaiqi Huang granule group according to the 1:1 simple distribution principle and the matched group.The matched groupwas given conventional drug-injection human immunoglobulin treatment,and the group was treated on the basis of the matched group.Both groups were treated for 3 months to observe the efficacy of treatment,platelet parameters,peripheral blood Treg/Th17 and CD4/CD8.Results:Post-treatment,the total effective rates of Huaiqihuang granule group were 96.7%,which were higher than 80.0%ofmatched group(P0.05).The onset time of Huaiqihuang granule group were shorter than that of the matched group,and the duration ofthe curative effect were longer than that of the matched group.there were difference compared between the two groups(P0.05).Theplatelet count and platelet parameters in the two groups Post-treatment were higher than those pretherapy,and the Huaiqihuang granulegroup were also higher than that in the matched group(P0.05).The Peripheral blood Treg/Th17 and CD4/CD8 in both groupspost-treatment were higher than that pretherapy,and the Huaiqihuang granule group were higher than that in the matched group(P0.05）。见表 1。表 1 一般资料对比Table 1 The comparison of the general dataGroupsnClinical stage(phase/phase/period)Disease course(month)Gender(male/female)Age(year)Weight(kg)Stature(cm)Huai Qi Huanggranule group3011/16/35.640.2516/146.230.3321.101.33121.0913.83Matched group3010/15/55.690.3415/156.290.1421.480.88121.5812.681.2 治疗方法对照组：给予常规药物治疗，采用注射用人免疫球蛋白（国药准字 s20113011，华兰生物工程重庆有限公司）给予 1 g/kg d静脉注射，连续应用 2 d，间隔 3-4 周行下一周期治疗。槐杞黄颗粒组：以对照组治疗为基础，给予槐杞黄颗粒治疗，每次口服槐杞黄颗粒（国药准字 B20020074，启东盖天力药业公司）5-10 g，2 次/d。两组都治疗观察 3 个月。1.3 观察指标（1）疗效标准：完全缓解：血小板计数 100109/L，且无出血症状；缓解：治疗后血小板计数30109/L，且无出血症状；无效：无达到上述标准甚或恶化。（完全缓解+缓解）/组内例数100.0%=总有效率。（2）测定与记录两组的起效时间与疗效维持时间，起效时间为从治疗开始，至血小板水平达至 30109/L 水平，且无出血症状；疗效维持时间：从治疗开始至复发或随访结束。（3）所有患儿在治疗前后抽取患儿的空腹外周静脉血2-3 mL，采用全自动生化分析仪检测血小板计数、血小板参数等指标。（4）所有患儿在治疗前后抽取骨髓，送检验科室测定与记录外周血 Treg/Th17 和 CD4/CD8 比值。1.4 统计方法本次研究统计软件为 SPSS22.00 进行分析，P0.05 表示差异有统计学意义。计量数据与计数数据以均数标准差、率表示，两两对比方法为 t 检验与卡方 x2检验等。2 结果2.1 总有效率对比治疗后槐杞黄颗粒组的总有效率为 96.7%，明显高于对照组的 80.0%（P0.05）。见表 2。Note:compared with the Matched group,#P0.05,the same below.表 2 两组治疗后总有效率对比(n)Table 2 Comparison of total effective rate between the two groups after treatment(n)GroupsnComplete remissionRemissionInvalidTotal effective rateHuai Qi Huang granulegroup30263129(96.7%)#Matched group30204624(80.0%)74现代生物医学进展Progress in Modern Biomedicine Vol.23NO.1JAN.20232.2 起效时间与疗效维持时间对比槐杞黄颗粒组的起效时间少于对照组，疗效维持时间多于对照组，两两对比有明显差异（P0.05）。见表 3。表 3 两组起效时间与疗效维持时间对比(均数标准差)Table 3 Comparison of onset time and efficacy maintenance time of the two groups(mean standard deviation)GroupsnEffective time(d)Efficacy maintenance time(month)Huai Qi Huang granule group3028.143.22#15.031.48#Matched group3034.392.5822.482.172.3 血小板计数、血小板参数变化对比两组治疗后的血小板计数、血小板参数都明显高于治疗前，槐杞黄颗粒组也明显高于对照组（P0.05）。见表 4。Note:compared with the pretherapy,*P0.05,the same below.表 4 两组治疗前后血小板计数、血小板参数变化对比(均数标准差)Table 4 Comparison of platelet count and platelet parameters before and post-treatment(mean standard deviation)GroupsnPlatelet count(1012/L)Platelet parametersPretherapyPost-treatmentPretherapyPost-treatmentHuai Qi Huang granule group300.210.031.760.24#*21.384.2071.733.33#*Matched group300.210.030.620.09*21.483.0245.295.19*2.4 外周血 Treg/Th17 和 CD4/CD8 比值变化对比两组治疗后的外周血 Treg/Th17 和 CD4/CD8 比值高于治疗前，槐杞黄颗粒组高于对照组（P0.05）。见表 5。表 5 两组治疗前后骨外周血 Treg/Th17 和 CD4/CD8 比值变化对比