再生障碍性贫血的中医证型特点及辨证用药效果探讨

摘要

目的：探讨再生障碍性贫血不同中医分型的血液实验室检查特点以及辨证用药治疗的效果。方法选取75例再生障碍性贫血患者，按照中医分型标准将患者分为肾阳虚型、肾阴虚型和肾阴阳两虚型，观察不同证型患者实验室指标以及治疗效果。结果①肾阴虚型患者WBC、RBC明显高于肾阳虚型以及肾阴阳两虚型（ P均＜0．05）；肾阳虚型、肾阴虚型和肾阴阳两虚型Plt呈依次递减，3组间差异有统计学意义（P均＜0．05）；Hb水平肾阳虚型明显低于其他2组（P均＜0．05）。②肾阳虚证患者CD3＋、CD8＋明显低于肾阴虚型及肾阴阳两虚组，而CD4＋与CD56＋16明显高于肾阴虚型以及肾阴阳两虚型，差异均有统计学意义（P均＜0．05）。③肾阳虚型髂骨部位骨髓增生明显减低（P＜0．05），胸骨增生活跃与减低差异无统计学意义（P＞0．05）；肾阴虚型胸骨部位增生活跃明显（P＜0．05），髂骨部位增生活跃和增生减低差异无统计学意义（P＞0．05）；阴阳两虚型胸骨和髂骨两处骨髓增生均明显减低（P均＜0．05）。④应用补肾中药治疗肾阳虚型效果最明显，有效反应率为83％，与其他2组比较差异有统计学意义（ P均＜0．05）；肾阴虚型治疗效果最差，有效反应率为66％。结论不同中医证型患者具有不同临床特征，治疗效果不一，需要根据患者病情演变辨证治疗。%Objective It is to investigate the characteristics of blood laboratory examination in different types of traditional Chinese medicine ( TCM) syndrome of aplastic anemia and the treatment effect of TCM syndrome differentiation.Methods 75 patients with aplastic anemia were divided into deficiency of kidney yang type, deficiency of kidney yin type, and deficiency of both kidney yin and yang type according to the TCM classification standards, and then the laboratory indexes in patients with different TCM syndrome type and therapeutic effect were observed.Results①The levels of WBC, RBC of patients with defi-ciency of kidney yin type was significantly higher than that of deficiency of kidney yang type and deficiency of both kidney yin and yang type (all P<0.05);the Plt levels in patients with deficiency of kidney yang type, deficiency of kidney yin type, and deficiency of both kidney yin and yang type were decreased in turn, there were significance difference among the three groups ( all P<0.05);the Hb levels in patients with deficiency of kidney yang type were significantly lower than the other two groups (all P<0.05).②The levels of CD3 +and CD8 +in patients with deficiency of kidney yang type were significantly low-er than those with deficiency of kidney yin type and deficiency of both kidney yin and yang type, but the levels of CD4 +and CD56 +16 were significantly higher than those, there were significant differences ( all P<0.05) .③The degree of ilium mar-row hyperplasia in deficiency of kidney yang type was significantly lower (P<0.05), but there was not significant difference between active and reduce of sternal hyperplasia (P>0.05);the sternal bone marrow hyperplasia in deficiency of kidney yin type was active significantly (P<0.05), but there was no significance difference between between active and reduce of ilial hyperplasia (P>0.05);the degrees of bone marrow hyperplasia in sternum and ilial of patients with deficiency of deficiency of both kidney yin and yang type were significantly lower (all P<0.05).④The effect of traditional Chinese medicine for in-vigorating the kidney in the treatment of deficiency of kidney yang type was most obvious, the effective response rate was 83%, there were significance difference compared with the other two groups (all P<0.05);the effect in the treatment of deficiency of kidney yin type was the worst, the effective response rate was 66%.Conclusion The patients with different TCM syndrome types have different clinical characteristics, different types of treatment effect is different, so it needs to be treated according to the patient's condition.