“补肾活血法”治疗慢性再生障碍性贫血疗效观察及对造血调控因子的影响

摘要

Objective] To study the cure effect of“Bushen Huoxue(tonify kidney to activate blood) Decoction”combined with western medicine on Chronic Aplastic Anemia(CAA) and the level change of hematopoiesis negative regulatory factors, and explore the effective method for CAA. [Method] (1)Choose 60 cases CAA patients from 2009 to 2011, randomly divide them into treatment and control groups; the control group take cyclosporine A combined with Mdriol or Stanozolol orally, the treatment group, added with TCM“Yixu Shengxue Decoction”, evaluate the cure effect after 6m of treatment. (2) Observe the said CAA 60 cases(group A), controlled with other 60 healthy persons(group B), test both groups’IFN-γ and TNF-α expression level in peripheral blood cell plasma with flow cytometry(FCM), and compare the negative hemopoiesis regulatory factors change in group A and control group. [Result] (1) The effective rate was 83.3% in treatment group, and 66.7% for control one, with difference of statistical meaning compared and checked by rank sum test;(2) In treatment group, the IFN-γ,TNF-αwere respectively 50.03±42.56 and 38.76±28.76 pg·mL-1,higher than group B, with difference of statistical meaning. After treatment, they were lowered markedly, with difference of statistical meaning compared with before treatment, but there’s no difference of statistical meaning compared with group B, referring to table 2;(3) In control group, the peripheral blood IFN-γ,TNF-αhad no obvious difference between before and after treatment; But they were raised much compared with group B, with difference of statistical meaning; (4)Comparing treatment group with control group, the IFN-γ, TNF-α had statistical difference before treatment, but the hemopoiesis negative regulatory factors lowered obviously after treatment, with statistical difference compared with control group. [Conclusion] “Bushen Huoxue method”can strengthen the cure effect of CAA by reducing negative hemopoiesis regulatory factors.%[目的]研究补肾活血的“益肾生血方”联合西药治疗慢性再生障碍性贫血（chronic aplastic anemia，CAA）疗效及造血负调控因子水平变化，探讨CAA的有效治疗方法。[方法]⑴选取2009年至2011年于本院血液科诊治的CAA患者60例，随机分为治疗组和对照组，对照组以环孢菌素A联合安雄或司坦唑醇口服，治疗组在对照组基础上加用“补肾活血”中药复方，治疗6个月后评估疗效。⑵观察上述CAA患者60例（设为A组），同时以健康体检者60例为对照（设为B组），通过流式细胞术检测治疗前两组外周血细胞浆中IFN-γ、TNF-α表达水平，并比较A组中治疗组和对照组上述负性造血调控因子的变化。[结果]⑴治疗组有效率为83.3%，对照组有效率为66.7%，经秩和检验比较，两组差异具有统计学意义（P<0.05）。⑵治疗组在治疗前IFN-γ、TNF-α分别为（50.03±42.56）pg·mL-1、（38.76±28.76）pg·mL-1，均高于B组，差异有统计学意义（P＜0.05）。治疗后显著下降，和治疗前比较差异有统计学意义（P＜0.05），与B组比较，差异无统计学意义（P＞0.05）。(3)对照组外周血IFN-γ、TNF-α水平治疗前、后比较无统计学差异（P＞0.05）。治疗前、后与B组比较均明显增高，差异有统计学意义（P＜0.05）。（4）治疗组和对照组比较，治疗前IFN-γ、TNF-α水平无统计学差异，但在治疗后治疗组造血负调控因子明显下降，和对照组比较有统计学差异（P＜0.05）。[结论]“补肾活血法”联合西药治疗CAA，可减少负性造血调控因子，增强患者治疗效果。