自体骨髓干细胞移植与中药合用治疗慢性下肢缺血性病变  

Treatment of Chronic Lower Limb Ischemia by the Integrated Therapy of Autologous Bone Marrow Stem Cell Transplantation and TCM Drugs

作　　者：杨博华[1] 秦建辉[1] 朱陵群[1] 陈蕾[1] 路红[1] 李友山[1] 周笑允[1] 

机构地区：[1]北京中医药大学附属东直门医院血管外科,北京100700

出　　处：《北京中医药大学学报》2004年第6期76-78,共3页Journal of Beijing University of Traditional Chinese Medicine

摘　　要：目的　研究自体骨髓单个核细胞移植与中药合用对下肢缺血的治疗作用。方法　治疗对象为 6例严重下肢缺血患者。术前用集落细胞刺激因子使患者骨髓处于增生活跃状态 ,抽取骨髓液后在血管外科专属干细胞工作室分离单个核细胞 ,细胞总量达到 1× 10 9L-1以上。移植采用缺血肢体多点注射。移植后 1d起服中药。观察患者手术前后肢体疼痛、冷感评分、踝肱指数 (ABI)以及溃疡创面情况 ,评价治疗效果。结果　治疗后 1周患者肢体疼痛评分及冷感评分明显下降 ,2周时又有回升 ,术后 1月再下降。ABI在术后逐渐升高 ,术后 1月平均升高 0 2 3。 3例有溃疡的患者创面明显缩小 ,2例有严重坏死者术后 1月行截趾 ,创面 1期愈合。结论　自体骨髓单个核细胞移植合用中药可以改善下肢缺血患者的临床症状及体征。Objective To investigate the efficacy of the integrated therapy of autologous bone marrow mononuclear cell transplantation and TCM drugs in the treatment of lower limb ischemia. Method 6 Cases of lower limb ischemia were involved in the clinical study. Before the operation, granulocyte colony stimulating factor (G-CSF) was used in the patients for making their bone marrow be in an active proliferation state. And then, the bone marrow fluid was aspirated for the separation of mononuclear Cells. The amount of the mononuclear cells in the separated fluid was over 1×10 9. The transplantation of the mononuclear cells was performed by the method of multipoint injection in the ischemic lower limb, and the TCM drugs were given to the patients from the first day after the operation. The efficacy of the integrated therapy was assessed by scoring lower limb pain intensity, poikilothermia, ankle-brachial index (ABI), and the area of the ulcerative surface in the patients before and after the operation. Results The scores of the lower limb pain intensity and poikilothermia markedly decreased in the patients one week after the treatment, then rebounded to some degree two weeks after the treatment, and went down again one month after the treatment. ABI increased gradually after the treatment, and the average value of the increased ABI was 0.23 one month after the treatment. After the treatment, the ulcerative area markedly shrank in the 3 cases with ulcerative surface; and toe amputation was performed in the 2 cases with severe putrescence one month after the treatment, and the incision got healed by first intention. Conclusion The integrated therapy of autologous bone marrow mononuclear cell transplantation and TCM drugs can relieve the clinical symptoms and signs in the patients of lower limb ischemia.

关 键 词：骨髓移植 单个核细胞 下肢缺血 中药治疗 

分 类 号：R269.544[医药卫生—中西医结合]