清肝化瘀汤治疗原发性血小板增多症以及与JAK2 V617F突变相关性的临床研究  

Clinical Research of Treatment of Essential Thrombocytosis with Qinggan Huayu Decocotion and Association between its Clinical Features and JAK2 V617F Point Mutation

作　　者：赵琳[1] 邱仲川[1] 朱小勤[1] 

机构地区：[1]上海中医药大学附属曙光医院,上海200021

出　　处：《辽宁中医杂志》2013年第4期728-730,共3页Liaoning Journal of Traditional Chinese Medicine

摘　　要：目的:探求原发性血小板增多症(ET)患者JAK2基因V617F突变和中医证候的相关性,以及清肝化瘀汤干预的疗效。方法:观察31例ET患者,其中JAK2 V617F突变阳性18例,阴性13例,两组均辨证应用清肝化瘀汤治疗,比较两组患者中医证候差别及与JAK2 V617F突变的相关性,观察治疗前后两组血常规、血液流变学变化。结果:治疗前JAK2 617F突变阳性组"刺痛"、"脉络瘀血"、"皮下瘀斑"积分高于突变阴性者,差异有显著性(P<0.05),两组的临床缓解率分别为83.3%、76.9%,差异无统计学意义(P>0.05),但JAK2 617F突变阳性组的中医证候、全血黏度改善优于阴性组,差异有统计学意义(P<0.05)。结论:JAK2 V617F突变阳性ET患者有更典型的瘀证表现,清肝化瘀汤可改善患者高凝高黏状态。Objective：To explore the association between the clinical features of essential thrombocytosis （ET）and the JAK2 V617F point mutation, and compare the therapeutic effect of Qinggan Huayu Decocotion（ QGHYD between patients with and without the mutation of JAK2 V617F point. Methods ：Observation of 31 ET- patients （18 with JAK2 V617F mutation, 13 without the mutation） was carried on. Both groups were treated with QGHYD based on syndrome differentiation and the TCM syndromes were compared to analyze the association between the mutation of JAK2 V617F and the TCM syndrome. We measured change of the peripheral blood and hemorheology before and after treatment. Results：For the group with JAK2 V617F mutation, the evaluation scores of sting, blood - stasis of arteries and veins, sub dermal ecchymosis were higher than those of the group without the muta- tion, the difference was statistically significant （ P 〈 0. 05 ）. The clinical remission rates of the two groups were respectively 83. 3% and 76.9% , the difference was not statistically significant （P 〉 0. 05） ;but the remission of TCM syndromes and whole blood viscosity improvement of the JAK2 V617F mutation positive group were better than those of the negative group, the difference was statistically significant （P 〈 0. 05）. Conclusion：The patients with JAK2 V617F mutation have a more typical clinical manifestation of blood stasis symptom. QGHYD can improve the hypercoagulable viscous state of patients with ET.

关 键 词：原发性血小板增多症 清肝化瘀汤 JAK2 V617F突变 

分 类 号：R558.3[医药卫生—血液循环系统疾病]