【摘要】 【目的】观察祛风法对凉血补肾中药治疗慢性特发性血小板减少性紫癜（ＣＩＴＰ）的疗效及其对免疫调节功能的影响。【方法】将４２例ＣＩＴＰ患者随机分为两组，治疗组２２例，予祛风凉血补肾法治疗；对照组２０例，予凉血补肾法治疗。两组均以６周为１个疗程，连续治疗３个疗程。观察两组临床疗效及治疗前后血清白介素２（ＩＬ２）、可溶性白介素２受体（sＩＬ２Ｒ）、Fas蛋白、FasＬ蛋白、血小板相关抗体（PAIgG）和淋巴细胞亚群等免疫学指标的变化。【结果】治疗组治愈１４例，显效５例，有效２例，无效１例，总有效率为９５５％；对照组治愈８例，显效４例，有效３例，无效５例，总有效率为７５０％；两组比较治疗组疗效优于对照组（Ｐ＜００５）。治疗后两组的血清ＩＬ２水平较治疗前显著性提高，sIL2R水平则显著性下降（与治疗前比较，Ｐ＜００１），且治疗组提高ＩＬ２、降低sIL2R的作用更明显（与对照组比较，Ｐ＜００５）。治疗后两组血小板Fas蛋白和FasL蛋白表达及PAIgG水平均下调（与治疗前比较，Ｐ＜００１），且治疗组的下调作用更明显（与对照组比较，Ｐ＜００５）。治疗后两组患者ＣＤ+４Ｔ细胞百分率、ＣＤ+４／ＣＤ+８比值均明显提高，ＣＤ+８Ｔ细胞百分率明显降低（与治疗前比较，Ｐ＜００５）。【结论】加用祛风药能提高凉血补肾中药治疗慢性特发性血小板减少性紫癜的疗效。
【关键词】 紫癜，血小板减少性／中药疗法；祛风；凉血；补肾
Influence of Winddispelling Therapy on Therapeutic Effect of Bloodcooling
and Kidneytonifying Herbs for Idiopathic Thrombocytopenic Purpura
DAI Mei，CHEN Zhixiong，YU Tianqi，YANG Hongguang，CHEN Yayong
1.Guangzhou Municipal Hospital of TCM,Guangzhou 510130 Guangdong,China;
2.The Third Affiliated Hospital,Guangzhou University of TCM,Guangzhou 510000 Guangdong,China
Abstract： Objective To observe the influence of winddispelling therapy on therapeutic effect of bloodcooling and kidneytonifying herbs for chronic idiopathic thrombocytopenic purpura (CITP),and to investigate its immunoregulatory effect.MethodsFortytwo CITP patients were randomized into 2 groups:the treatment group (N=22) received therapy of dispelling wind,cooling blood and tonifying kidney,and the control group (N=20) received therapy of cooling blood and tonifying kidney.Six weeks constituted one treatment course,and the treatment lasted 3 courses.Serum interleukin 2 (IL2),soluble IL2 receptor (sIL2R),Fas protein,FasL protein,and plateletassociated immunoglobulin G (PAIgG) levels and lymphocyte subtypes were compared before and after treatment.ResultsIn the treatment group,14 patients were clinically cured,5 markedly effective,2 effective,1 inef
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