复方参鹿颗粒干预钙结合蛋白S100A8/A9改善较低危骨髓增生异常综合征患者无效造血机制研究  

Study on Mechanism of Intervention of Compound Shenlu Granules in S100A8/A9 for Improving Ineffective Hematopoiesis in Patients with Lower-risk Myelodysplastic Syndrome

作　　者：瞿玮颖 邱仲川[1] 陈珮[1] 黄中迪[1] 胡晓莹[1] 朱小勤[1] 陆颖佳[1] 谈栩铖 赵琳[1] QU Weiying;QIU Zhongchuan;CHEN Pei;HUANG Zhongdi;HU Xiaoying;ZHU Xiaoqin;LU Yingjia;TAN Xucheng;ZHAO Lin(Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 200021,China)

机构地区：[1]上海中医药大学附属曙光医院

出　　处：《中国中医药信息杂志》2019年第9期20-24,共5页Chinese Journal of Information on Traditional Chinese Medicine

基　　金：国家自然科学基金青年基金(81403233)

摘　　要：目的观察复方参鹿颗粒对较低危骨髓增生异常综合征(MDS)患者钙结合蛋白S100A8、S100A9的影响,探讨其改善无效造血的作用机制。方法采用随机数字表法将60例较低危MDS患者分为治疗组和对照组各30例。治疗组予复方参鹿颗粒,每次1包,每日3次,口服;对照组予十一酸睾酮胶丸,每次40 mg,每日3次,口服。2组均连续治疗3个月。比较2组临床疗效,观察2组治疗前后外周血细胞计数、肿瘤坏死因子-α(TNF-α)、干扰素-γ(IFN-γ)、血管内皮生长因子(VEGF),钙结合蛋白S100A9、S100A8、S100A8/A9和p-p38蛋白表达及其相关性。结果治疗组总有效率为85.7%(24/28),对照组为71.4%(20/28),2组比较差异无统计学意义(P>0.05)。与本组治疗前比较,2组治疗后红细胞、血红蛋白、血小板计数明显升高(P<0.05,P<0.01)。与本组治疗前比较,治疗组治疗后TNF-α、IFN-γ、VEGF水平明显下降(P<0.01);2组治疗后比较,治疗组TNF-α、IFN-γ明显低于对照组(P<0.05,P<0.01)。与正常组比较,2组治疗前S100A8、S100A9、S100A8/A9水平明显升高(P<0.01),p-p38蛋白表达明显增加(P<0.05,P<0.01);与本组治疗前比较,治疗组治疗后S100A8、S100A9、S100A8/A9水平明显下降(P<0.01),p-p38蛋白表达明显降低(P<0.01)。2组治疗前S100A8、S100A9、S100A8/A9与TNF-α、IFN-γ、VEGF、p-p38蛋白表达呈正相关(P<0.01)。治疗组治疗后S100A8、S100A9、S100A8/A9与总有效率、红细胞、血红蛋白呈正相关(P<0.01)。结论复方参鹿颗粒可有效改善较低危MDS患者无效造血,其机制可能与下调S100A8、S100A9、S100A8/A9活性,抑制p-p38表达,减少细胞因子分泌有关。Objective To observe the effects of Compound Shenlu Granules on calcium binding protein S100A8 and S100A9 in patients with lower-risk myelodysplastic syndromes(MDS);To explore its mechanism of improving ineffective hematopoiesis.Methods Totally 60 lower-risk MDS patients were divided into treatment group and control group according to random number table method,with 30 cases in each group.Treatment group was given Compound Shenlu Granules,1 pack each time,three times a day,orally;while control group was given andriol capsule,40 mg each time,three times a day,orally.The treatment for both groups lasted for 3 months.Clinical efficacy,blood cell counts,changes of cytokines such as TNF-α,IFN-γ,VEGF,calcium-binding proteins S100A8,S100A9,S100A8/A9,and p-p38 protein expression levels before and after treatment in the two groups and their correlation were observed.Results The total effective rate was 85.7%(24/28)in the treatment group and 71.4%(20/28)in the control group,without statistical difference in the two groups(P>0.05).Compared with before treatment,the erythrocyte,hemoglobin and platelet counts of the two groups significantly increased after treatment (P<0.05, P<0.01). Comparedwith before treatment, the levels of TNF-α, IFN-γ and VEGF in the treatment group decreased significantly (P<0.01);After treatment, the TNF-α and IFN-γ in the treatment group were significantly lower than those in the control group(P<0.05, P<0.01). Compared with the normal group, the concentrations of S100A8, S100A9, and S100A8/A9significantly increased in the two groups before treatment (P<0.01), and the expression of p-p38 protein significantlyincreased (P<0.05, P<0.01). The expressions of S100A8, S100A9 and S100A8/A9 were positively correlated with theexpressions of TNF-α, IFN-γ, VEGF and p-p38 (P<0.01) in both groups before treatment. S100A8, S100A9 andS100A8/A9 were positively correlated with total effective rate, red blood cells and hemoglobin (P<0.01) in thetreatment group after treatment. Conclusion Compound Shenlu Granule

关 键 词：复方参鹿颗粒 骨髓增生异常综合征 S100A8 S100A9 S100A8/A9 磷酸化P38 

分 类 号：R259.513[医药卫生—中西医结合]