金卷升板方治疗持续性原发免疫性血小板减少症回顾性研究OA

Objective To observe the clinical efficacy and safety of the Jinjuan Shengban formula in the treatment of persistent primary immune thrombocytopenia(ITP).Methods A retrospective analysis was conducted on 70 patients with persistent ITP treated with the Jinjuan Shengban formula in the outpatient department of the First Hospital of Hebei Medical University from June 2016 to June 2022,serving as the observation group.In addition,30 patients with persistent ITP treated with glucocorticoid methylprednisolone during the same period and matched for sex and age were selected as the control group.Clinical efficacy and adverse reactions were observed in both groups.Result In the observation group(n=70),32 cases(45.7%)achieved complete response(CR),30 cases(42.8%)showed response(R),and 8 cases(11.4%)showed no response(NR),with a total response rate of 88.6%(62/70).Among responders,62 cases(88.6%)achieved sustained efficacy(DR),56 cases achieved remission(Rem,80.0%),and 8 cases relapsed(Rel,8/62,12.9%).In the control group(n=30),17 cases(56.7%)achieved CR,8 cases(26.7%)showed R,and 5 cases(16.7%)showed NR,with a total response rate of 83.3%(25/30).Among responders,2 cases(6.7%)achieved DR,1 case achieved Rem(3.3%),and 21 cases Rel(21/25,84.0%).There was no statistically significant difference in total response rate between the two groups(P=0.523).The sustained DR in the observation group was significantly higher than that in the control group(P=0.000),while the Rel in the observation group was significantly lower than that in the control group(P<0.001).Early response(ER:0/70)and initial response(IR:8/70)in the observation group were lower than those in the control group(ER:5/30;IR:18/30),with statistically significant differences(PER=0.027,PIR=0.000).There was no statistically significant difference in efficacy between platelet antibody-negative and-positive patients in the observation group(80%vs.86.8%,P=0.849)or in the control group(100%vs.75%,P=0.285).The main adverse reactions in the observation group were mild gastrointestinal symptoms.In the control group,adverse reactions included elevated blood glucose,elevated blood pressure,and lower limb edema.Conclusion The Jinjuan Shengban formula demonstrates favorable long-term efficacy in the treatment of persistent ITP,with a low relapse rate and mild adverse reactions.Methylprednisolone shows a rapid onset of effect but poorer long-term efficacy,a higher relapse rate,and more significant adverse reactions.