目的 探討升血小板膠囊聯(lián)合艾曲泊帕乙醇胺片治療原發(fā)免疫性血小板減少癥的臨床療效。方法 選取邯鄲市第一醫(yī)院在2022年3月—2024年12月收治的88例原發(fā)免疫性血小板減少癥患者，所有患者按隨機(jī)數(shù)字表法分為對照組和治療組，44例/組。對照組患者口服艾曲泊帕乙醇胺片，1次/d，首次劑量25 mg/d，監(jiān)測血小板（PLT）數(shù)量調(diào)整劑量，最大劑量75 mg/d。治療組在對照組基礎(chǔ)上口服升血小板膠囊，3次/d，4粒/次。兩組患者持續(xù)完成3個月的治療。比較兩組患者的治療效果、出血評分、炎癥因子、淋巴細(xì)胞、血小板。結(jié)果 治療后，治療組、對照組的總有效率分別為93.18%、79.55%，組間比較差異顯著（P＜0.05）。兩組治療后的出血評分顯著降低（P<0.05），治療組治療后的出血評分低于對照組（P＜0.05）。兩組治療后的腫瘤壞死因子相關(guān)凋亡誘導(dǎo)配體（TRAIL）、可溶性基質(zhì)裂解素2（sST2）顯著降低，白細(xì)胞介素-37（IL-37）、PLT顯著升高（P＜0.05）；治療組治療后的TRAIL、sST2低于對照組，IL-37、PLT高于對照組（P＜0.05）。兩組治療后的Treg細(xì)胞、Treg/Th17明顯升高，Th17細(xì)胞明顯降低（P＜0.05）；治療組治療后的Treg細(xì)胞、Treg/Th17高于對照組，Th17細(xì)胞低于對照組（P＜0.05）。結(jié)論 升血小板膠囊聯(lián)合艾曲泊帕乙醇胺片可提高原發(fā)免疫性血小板減少癥的臨床療效，減輕出血程度，降低炎癥反應(yīng)，調(diào)節(jié)Treg/Th17平衡。

Objective To explore the clinical efficacy of Shengxuexiaoban Capsules combined with Eltrombopag Olamine Tablets in treatment of primary immune thrombocytopenia. Methods A total of 88 patients with primary immune thrombocytopenia admitted to the Handan First Hospital from March 2022 to December 2024 were selected. All patients were randomly divided into control group and treatment group using a random number table method, with 44 patients in each group. The control group patients were po administered with Eltrombopag Olamine Tablets, once daily, with an initial dose of 25 mg/d. Platelet number was monitored and adjusted to a maximum dose of 75 mg/d. The treatment group took orally Shengxuexiaoban Capsules on the basis of the control group, 3 times daily, 4 capsules per time. Two groups of patients completed a continuous 3-month treatment. The treatment efficacy, bleeding score, inflammatory factors, lymphocytes, and platelets (PLT) were compared between two groups. Results After treatment, the total effective rates of the treatment group and the control group were 93.18% and 79.55%, respectively, with significant differences between the groups (P < 0.05). The bleeding scores of two groups were significantly decreased after treatment (P < 0.05), and the bleeding scores of the treatment group was lower than those of the control group after treatment (P < 0.05). After treatment, the levels of tumor necrosis factor related apoptosis inducing ligand (TRAIL) and soluble matrix metalloproteinase-2 (sST2) were significantly reduced in two groups, while interleukin-37 (IL-37) and PLT were significantly increased (P < 0.05). The TRAIL and sST2 levels in the treatment group were lower than those in the control group after treatment, while IL-37 and PLT levels were higher than those in the control group (P < 0.05). After treatment, the levels of Treg cells and Treg/Th17 were significantly increased in two groups, while Th17 cells were significantly decreased (P < 0.05). The Treg cells and Treg/Th17 in the treatment group were higher than those in the control group after treatment, while Th17 cells were lower than those in the control group (P < 0.05). Conclusion Shengxuexiaoban Capsules combined with Eltrombopag Olamine Tablets can improve the efficacy of primary immune thrombocytopenia, reduce the degree of bleeding, reduce the inflammatory response, and regulate the balance of Treg/Th17.

R973

邯鄲市科學(xué)技術(shù)研究與發(fā)展計劃項(xiàng)目（23422083273）