滋阴益肾法治疗特发性血小板减少性紫癜疗效及对患者血清IL-4、IL-6和免疫功能的影响

目的: 探讨滋阴益肾法治疗特发性血小板减少性紫癜(ITP)的疗效及对血清IL-4、IL-6、TNF-α及免疫功能的影响。方法:选取ITP患者84例,随机数字表法分为对照组和观察组,各42例。对照组采用口服泼尼松片治疗,观察组在对照组用药基础上给予滋阴益肾法治疗。比较两组临床疗效,治疗前后IL-4、IL-6、TNF-α、外周血T淋巴细胞亚群(CD₃⁺、CD₄⁺、CD₈⁺、CD₄⁺ /CD₈⁺)及免疫球蛋白水平变化情况。结果:两组治疗后中医症候积分明显降低,观察组优于对照组(P<0.05)。观察组总有效率95.24%高于对照组78.57%(P<0.05); 两组治疗后PLT计数均明显升高、PAIgG表达水平降低,观察组更明显(P<0.05); 两组治疗前IL-4、IL-6、TNF-α及外周血T淋巴细胞亚群水平比较差异无统计学意义(P>0.05); 治疗后CD₃⁺、CD₄⁺、CD₄⁺ /CD₈⁺均升高,IL-4、IL-6、TNF-α、CD₈⁺均降低(P<0.05); 观察组治疗后CD₃⁺、CD₄⁺、CD₄⁺ /CD₈⁺均高于对照组,IL-4、IL-6、TNF-α、CD₈⁺均低于对照组(P<0.05)。治疗后观察组的血清IgA和IgG水平明显高于对照组(P<0.05),而血清IgM水平差异无统计学意义(P>0.05)。两组不良反应情况比较无统计学差异(P>0.05)。结论: 滋阴益肾法可显著降低ITP患者血清IL-4、IL-6等因子水平,提高患者免疫能力。

Therapeutic effect of Ziyin Yishen therapy on idiopathic thrombocytopenic purpura and its effects on serum IL-4,IL-6 and immune function in patients with idiopathic thrombocytopenic purpura

Objective:To investigate the therapeutic effect of Ziyin Yishen therapy on idiopathic thrombocytopenic purpura(ITP)and its effects on serum IL-4,IL-6,TNF-alpha and immune function.Methods:84 ITP patients were divided into control group and observation group by random number method,42 cases in each group.The control group was treated with oral prednisone tablets,while the observation group was treated with Ziyin Yishen therapy on the basis of the control group.The clinical effects of the two groups were compared.The levels of IL-4,IL-6,TNF-alpha and T lymphocyte subsets(CD3^+,CD4^+,CD8^+,CD4^+/CD8^+)in peripheral blood were measured before and after treatment.Results:After treatment,the scores of TCM symptoms in the two groups were significantly reduced,and the observation group was better than the control group(P<0.05).The total effective rate of the observation group was 95.24%higher than that of the control group(78.57%,P<0.05).After treatment,PLT counts increased significantly and PAIgG expression decreased in both groups,especially in the observation group(P<0.05).There was no significant difference in the levels of IL-4,IL-6,TNF-alpha and T lymphocyte subsets in peripheral blood between the two groups before treatment(P>0.05).CD4^+/CD8^+increased,IL-4,IL-6,TNF-alpha and CD8+decreased(P<0.05);after treatment,CD3^+,CD4^+,CD4^+/CD8^+in the observation group were higher than those in the control group,and IL-4,IL-6,TNF-alpha and CD8^+were lower than those in the control group(P<0.05).After treatment,the serum IgA and IgG levels in the observation group were significantly higher than those in the control group(P<0.05),but there was no significant difference in serum IgM levels(P>0.05).There was no significant difference in adverse reactions between the two groups(P>0.05).Conclusion:Ziyin Yishen therapy can significantly reduce the level of serum IL-4,IL-6and other factors in ITP patients,and improve the immune ability of patients.