目的 探讨槐杞黄颗粒联合艾曲泊帕乙醇胺片治疗儿童难治性免疫性血小板减少症的临床效果。方法 选取2020年1月—2022年7月河北省儿童医院收治的60例儿童难治性免疫性血小板减少症患儿，将60例患儿用随机数字表法分为对照组（30例）和治疗组（30例）。对照组口服艾曲泊帕乙醇胺片，初始剂量25 mg/d，随后根据血小板计数（PLT）调整剂量。治疗组在对照组基础上开水冲服槐杞黄颗粒，1袋/次，2次/d。两组均治疗6个月。比较两组的临床疗效、PLT和免疫功能。结果 治疗后，治疗组总有效率显著高于对照组（P＜0.05）。治疗后，两组PLT较治疗前均显著升高（P＜0.05），且治疗组的PLT高于对照组（P＜0.05）。治疗后，两组CD3⁺、CD4⁺、CD4⁺/CD8⁺水平均明显升高，CD8⁺明显降低（P＜0.05）；治疗后，治疗组CD3⁺、CD4⁺、CD4⁺/CD8⁺水平均高于对照组，CD8⁺低于对照组（P＜0.05）。结论 槐杞黄颗粒联合艾曲泊帕乙醇胺片治疗儿童难治性免疫性血小板减少症具有较好临床疗效，能够在短期内快速提升患儿PLT水平，增强免疫功能。

Objective To explore clinical effect of Huaiqihuang Granules combined with Eltrombopag Olamine Tablets in treatment of refractory immune thrombocytopenia in children. Methods Children (60 cases) with refractory immune thrombocytopenia in Hebei Children’s Hospital from January 2020 to July 2022 were divided into control and treatment groups according to random number tablet method, and each group had 30 cases. Children in the control group were po administered with Eltrombopag Olamine Tablets, the initial dose was 25 mg/d, and then the dose was adjusted based on PLT count. Children in the treatment group were po administered with Huaiqihuang Granules on the basis of the control group, 1 bag/time, twice daily. Patients in two groups were treated for 6 months. The clinical efficacies, PLT, and immune function in two groups were compared. Results After treatment, the total effective rate of the treatment group was significantly higher than that in the control group, with a statistically significant difference (P＜0.05). After treatment, PLT in two groups was significantly higher than that before treatment (P＜ 0.05), and PLT in treatment group was higher than that in control group (P＜ 0.05). After treatment, the levels of CD3⁺, CD4⁺, and CD4⁺/CD8⁺ in two groups were increased, but the levels of CD8⁺ were decreased (P＜0.05). After treatment, the levels of CD3⁺, CD4⁺, and CD4⁺/CD8⁺ in the treatment group were higher than those in the control group, and the levels of CD8⁺ were lower than those in the control group (P＜ 0.05). Conclusion Huaiqihuang Granules combined with Eltrombopag Olamine Tablets has clinical effect in treatment of refractory immune thrombocytopenia in children, can rapidly increase the PLT level of children and enhance immune function.

R973

河北省医学科学研究课题计划项目（20190825）