中文摘要：

目的：探讨加减归脾汤治疗免疫性血小板减少性紫癜（ITP）的免疫学作用机制。方法：将我院2012年12月~2013年12月门诊及住院收治的42例ITP患者随机分为对照组及治疗组各21例,治疗组予加减归脾汤治疗,对照组予泼尼松治疗。治疗2个月后,比较两组治疗前后血小板计数（PLT）,同时采用酶联免疫吸附测定法（ELISA）检测两组治疗前后的IL-18、IL-18BP、GPⅡb/Ⅲa含量并进行比较。结果：治疗组与对照组比较,总有效率分别为90.5%和95.2%,两组差异无统计学意义（P〉0.05）。两组治疗前后IL-18、IL-18BP、GPⅡb/Ⅲa差异有统计学意义（P〈0.05）。治疗组与对照组比较,IL-18、IL-18BP、GPⅡb/Ⅲa含量差异无统计学意义（P〉0.05）。结论：加减归脾汤治疗ITP疗效与泼尼松相当,其免疫学作用机制可能既与体液免疫有关又与细胞免疫有关。

英文摘要：

Objective： To discuss the immunological mechanisms of modified spleen-invigorating decoction treatment of immune thrombocytopenic purpura （ITP）. Methods： 42 out-patients and in-patients with ITP from December 2012 to December 2013 were randomly divided into a control group and a treatment group （N = 21 ）. The treatment group was given modified spleen-invigorating decoction. The control group was given prednisone. Comparative study on platelet count （PLT） was made after two months of treatment. Enzyme-linked immunosorbent assay （ELISA） was used to detect the contents of IL - 18,IL - 18BP, GP II b/ma before and after the treatment in both groups. Methods： The total effective rate in the treatment group was 90. 5%, meanwhile, 95.2% in the control group. Compared the two groups, the differences were not statistically significant （P 〉 0. 05）. Differences of IL - 18, IL - 18BP and GP 11 b/llIa before and after treatment were statistically significant （P 〈0. 05）. Compared the two groups, differences of IL- 18, IL- 18BP and GP Ⅱb/Ⅲa contents were not statistically significant（ P 〉 0. 05 ）. Conclusion： The immunological mechanisms of modified spleen-invigor- ating decoction in the treatment of ITP were probably associated with humoral immunity and cellular immunity.