脾虚型出血性血小板病患者ADAM17的表达变化及健脾益气活血方的治疗作用  

The expression of ADAM17in patients with hemorrhagic thrombopathyof spleen deficiency syndromeand effect of prescription for invigorating spleen function reinforcing vital Qi and activating blood circulation

作　　者：杨胜兰[1] 沈霖[1] 张红星[2] 赵光 凌家艳[2] 秦铀[1] 帅波[1] 朱锐[1] 

机构地区：[1]华中科技大学同济医学院附属协和医院中西医结合科,湖北武汉430022 [2]武汉市第一医院中医科,湖北武汉430022 [3]武汉市第三医院妇产科,湖北武汉430060

出　　处：《中国中西医结合消化杂志》2015年第2期75-78,共4页Chinese Journal of Integrated Traditional and Western Medicine on Digestion

基　　金：国家自然科学基金资助项目(No:81072945;No:81102692)

摘　　要：[目的]研究健脾益气活血方对脾虚型出血性血小板病患者解离素金属酶(ADAM)17表达的影响,探讨其治疗该病的可能机制。[方法]将212例脾虚型出血性血小板病患者随机分为中药组与西药组,另选52例健康献血员作为正常对照组。中药组142例用健脾益气活血方治疗,西药组70例用安络血治疗,2组均治疗2个月;观察2组治疗后的止血疗效及血小板聚集恢复率;采用酶联免疫吸附法检测2组治疗前后及正常对照组的血浆ADAM17含量。[结果]中药组止血总有效率为83.82%;西药组为46.15%(P<0.01);中药组血小板聚集功能恢复率67.94%,西药组仅5.17%,检验2组间差异有统计学意义(P<0.001)。2组患者治疗前ADAM17含量均高于正常对照组(P<0.05);中药组治疗2个月后,ADAM17下降,与正常组比较差异无统计学意义,与西药组治疗后比较,差异有统计学意义(P<0.05)。[结论]健脾益气活血方降低脾虚型出血性血小板病患者高于正常的ADAM17含量,减少其对凝血酶受体过度水解,可能是该方止血和恢复血小板聚集功能的部分疗效机制之一。[Objective]To observe the effect of prescription for invigorating spleen function reinforcing vital Qi and activating blood circulation（ISFRVQABC）on the expression levels of a disintegrin and metalloproteinase 17（ADAM17）in patients with hemorrhagic thrombopathy（HT）of spleen deficiency syndrome,and to explore its possible mechanism.[Methods]Two hundred and twelve patients with HT of spleen deficiency syndrome were randomly divided into TCM group and western medicine group,52 healthy donors served as normal control group.The TCM group（142cases）treated with prescription for ISFRVQABC and the western medicine group（70cases）treated with adrenosin for 2months.The hemostatic efficacy and therecovery rate of platelet aggregation in the two groups were observed.And plasma levels of ADAM 17 were analyzed by Enzyme-linked immunosorbent assay in both groups before and after the treatment and in the normal control people.[Results]The hemostatic effective rate was 83.82%in TCM group and 46.15%in western medicine group（P〈0.01）,the recovery rate of platelet aggregation was 67.94%and 5.17%respctively（P〈0.001）.The plasma level of ADAM 17 was higher in both groups before treatment than that in the healthy subjects,ADAM 17 was elevated in TCM group after 2months,and that in TCM group has no significant difference as compared with the healthy subjects and lower than in the western medicine group（P〈0.05）.[Conclusion]The partial mechanism of treating HT of spleen deficiency syndrome with prescription for ISFRVQABC is related to reducing ADAM 17 content in the plasma,inhibiting excessive hydrolysis for Thrombin receptor.

关 键 词：出血性血小板病 解离素金属酶17 脾虚 健脾益气活血方 

分 类 号：R735.2[医药卫生—肿瘤]