Abstract：Objective To explore the differences in clinical blood indicators among different traditional Chinese medicine syndromes in primary immune thrombocytopenia (ITP), and to provide reference for the clinical diagnosis and treatment of ITP. Methods A total of 124 hospitalized patients with confirmed ITP from January 2019 to December 2022 in the Department of Hematology and Oncology, the First Affiliated Hospital of Hunan University of Chinese Medicine were collected. Differences in clinical blood indexes (coagulation function, blood routine, lymphocyte subpopulations, cytokines) were compared between different traditional Chinese medicine evidence types of ITP. Results According to different syndrome types, 124 ITP patients were divided into failure of keeping fluid due to qi-deficiency group(36 cases), yin deficiency and blood heat group(27 cases), internal blockage due to blood stasis group (15 cases), and bleeding due to blood heat group (46 cases). There was significant difference in gender composition among all groups (P＜0.001). The age of yin deficiency and blood heat group and internal blockage due to blood stasis group was higher than that of failure of keeping fluid due to qi deficiency group, and the difference was statistically significant (P＜0.05 or P＜0.01). The age of the yin deficiency and blood heat group was higher than that of the bleeding due to blood heat group, and the differences were statistically significant (P＜0.05). The hospitalization days in the internal blockage due to blood stasis group were longer than those in the failure of keeping fluid due to qi deficiency and bleeding due to blood heat group, and the differences were statistically significant (P＜0.01). The fibrinogen of internal blockage due to blood stasis group was lower than that of yin deficiency and blood heat group, and the difference was statistically significant (P＜0.05). The white blood cells count in the internal blockage due to blood stasis group were lower than those in the yin deficiency and blood heat group and the bleeding due to blood heat group, and the differences were statistically significant (P＜0.05). The hemoglobin of yin deficiency and blood heat group was higher than that of failure of keeping fluid due to qi deficiency group, the difference was highly statistically significant (P＜0.01). The platelets count in the internal blockage due to blood stasis group were higher than those in other syndrome groups, and the differences were statistically significant (P ＜ 0.05). The ratio of CD4+T cells and CD4 / CD8 in the bleeding due to blood heat group was lower than that in the yin deficiency and blood heat group, the differences were statistically significant (P＜0.05). The CD3 / CD8 ratio in the bleeding due to blood heat group was lower than that in the yin deficiency and blood heat group and the internal blockage due to blood stasis group, and the differences were statistically significant (P＜0.01). The levels of interleukin-6 and interleukin-10 in the bleeding due to blood heat group were lower than those in other syndrome groups, and the differences were statistically significant (P＜0.05). Tumor necrosis factor-α in the bleeding due to blood heat group was higher than that in other syndrome groups, and the differences were statistically significant (P＜0.05). Conclusion There are differences in blood indicators among different traditional Chinese medicine syndrome of ITP, which can provide objective basis for the Traditional Chinese medicine diagnosis and treatment of primary immune thrombocytopenia.
赵华林 刘津源 赵早云. 不同中医证型原发性免疫性血小板减少症患者临床血液指标的比较[J]. 中国医药导报, 2023, 20(35): 159-163.
ZHAO Hualin LIU Jinyuan ZHAO Zaoyun. Comparison of clinical haematological indices in patients with primary immune thrombocytopenia of different traditional Chinese medicine syndromes. 中国医药导报, 2023, 20(35): 159-163.
[1] 徐皓，鲍计章，周永明.原发免疫性血小板减少症的发病机制的研究进展[J].医学研究杂志，2019，48（11）：184- 187，176. [2] 王蕾，贺小宁，李正翔，等.原发免疫性血小板减少症患者真实世界治疗现状与疾病负担研究[J].中国医院药学杂志，2023，43（14）：1602-1607. [3] Cooper N，Ghanima W. Immune Thrombocytopenia [J]. N Engl J Med，2019，381（10）：945-955. [4] 杨秀鹏，许勇钢，麻柔，等.益气通阳颗粒对免疫性血小板减少症模型小鼠的治疗作用及机制[J].北京中医药大学学报，2023，46（4）：502-508. [5] 贾钰洁，何靖，马萌.基于营卫和六经病中风理论辨治免疫性血小板减少症[J].中医杂志，2022，63（18）：1793- 1796. [6] 王攀，蔺亚东，武曲星，等.免疫性血小板减少症气不摄血证小鼠外周血小板活化功能的研究[J].中国比较医学杂志，2020，30（7）：45-50. [7] 李晓征，白玉盛，王永，等.不同证型原发免疫性血小板减少症患者淋巴细胞亚群表达特征[J].中医杂志，2017，58（13）：1126-1129. [8] 郑筱萸.中药新药临床研究指导原则（试行）[M].北京：中国医药科技出版社，2002：124-129. [9] 张旻昱，蒋文明.中西医结合治疗免疫性血小板减少症临床疗效Meta分析[J].中国中医药信息杂志，2014，21（3）：5-9. [10] 李露.升板膏治疗原发免疫性血小板减少症（阴虚火旺夹瘀证）临床疗效观察[D].长沙：湖南中医药大学，2019. [11] 沈悌，赵永强.血液病诊断及疗效标准[M].4版.北京：科学出版社，2018：186-190. [12] 孙香娟，严方利，王艳，等.试从“卫气津营血精神”七纲论治过敏性紫癜[J].世界科学技术-中医药现代化，2023， 25（2）：473-477. [13] González-López TJ，Provan D，Bárez A，et al. Primary and secondary immune thrombocytopenia（ITP）：Time for a rethink [J]. Blood Rev，2023，61：101112. [14] Liu XG，Hou Y，Hou M. How we treat primary immune thrombocytopenia in adults [J]. J Hematol Oncol，2023，16（1）：4. [15] Rui X，Fu Y，Cai J，et al. Gut microbiota were altered with platelet count and red blood cell count in immune thrombocytopenia patients with different treatments [J]. Front Cell Infect Microbiol，2023，13：1168756. [16] 杨秀鹏，许勇钢，麻柔，等.益气通阳颗粒对免疫性血小板减少症模型小鼠的治疗作用及机制[J].北京中医药大学学报，2023，46（4）：502-508. [17] Xia Y，Liu A，Li W，et al. Reference range of na?觙ve T and T memory lymphocyte subsets in peripheral blood of healthy adult [J]. Clin Exp Immunol，2022，207 （2）：208-217. [18] Lin X，Xu A，Zhou L，et al. Imbalance of T Lymphocyte Subsets in Adult Immune Thrombocytopenia [J]. Int J Gen Med，2021，14：937-947. [19] Elsayh KI，Saad K，Osman NS，et al. Regulatory T-lymphocyte subsets in children with chronic immune thrombocytopenia after high-dose of dexamethasone [J]. Pediatr Res，2022，92（5）：1432-1436. [20] Wu Z，Zheng Y，Sheng J，et al. CD3+ CD4- CD8- （Double- Negative） T Cells in Inflammation，Immune Disorders and Cancer [J]. Front Immunol，2022，13：816005. [21] Qin J，Liu Q，Liu A，et al. Empagliflozin modulates CD4+ T-cell differentiation via metabolic reprogramming in immune thrombocytopenia [J]. Br J Haematol，2022，198（4）：765-775. [22] Malik A，Sayed AA，Han P，et al. The role of CD8+ T-cell clones in immune thrombocytopenia [J]. Blood，2023，141（20）：2417-2429. [23] Lazarus AH，Semple JW. TEMRA：the CD8 subset in chronic ITP? [J]. Blood，2023，141（20）：2409-2410. [24] Stimpson ML，Lait PJP，Schewitz-Bowers LP，et al. IL-10 and IL-17 expression by CD4+ T cells is altered in corticosteroid refractory immune thrombocytopenia （ITP）[J]. J Thr- omb Haemost，2020，18（10）：2712-2720. [25] Kostic M，Zivkovic N，Cvetanovic A，et al. CD4+ T cell phenotypes in the pathogenesis of immune thrombocytopenia [J]. Cell Immunol，2020，351：104096.
2023, Vol. 20 
京公网安备 11010502046598号