补肾生血法治疗再生障碍性贫血的作用机制研究  

Study on Mechanism of Tonifying Kidney and Generating Blood Method in Treatment of Aplastic Anemia

作　　者：栾岚[1] 刘春雨[1] 陈楠楠[1] LUAN Lan;LIU Chunyu;CHEN Nannan(PLA 967 Hospital,Dalian 116021,Liaoning,China)

机构地区：[1]中国人民解放军联勤保障部队第九六七医院,辽宁大连116021

出　　处：《辽宁中医杂志》2020年第3期127-130,共4页Liaoning Journal of Traditional Chinese Medicine

基　　金：国家科技支撑计划课题(2017BAI10B01-099)。

摘　　要：目的探究补肾生血法治疗再生障碍性贫血的作用机制。方法选取2018年3月-2019年5月收治的再生障碍性贫血患者98例,采用随机数字表法分为对照组和观察组,各49例。两组均进行抗感染、补充血液成分等对症支持治疗,对照组给予环孢素软胶囊口服治疗,观察组加用补肾生血汤口服治疗。两组均治疗6个月。治疗结束后观察两组血红蛋白、白细胞、血小板、网织红细胞计数以及淋巴细胞百分率,血清白细胞介素,T淋巴细胞亚群,相关基因转录因子孤独核受体γt,叉状转录因子mRNA的表达情况,外周血免疫细胞Treg及Th17的水平。结果观察组总有效率为97.95%(48/49),明显高于对照组的83.67%(41/49)(P<0.05)。观察组治疗后外周血WBC、HGB、PLT、RET及Ly百分率明显优于对照组(P<0.05)。观察组治疗后血清白细胞介素IL-6、IL-17、IL-23均明显低于对照组(P<0.05)。观察组治疗后CD4+、CD4+/CD8+均明显高于对照组(P<0.05)。观察组治疗后Foxp3 mRNA、Foxp3/RORγt均明显高于对照组(P<0.05)。观察组治疗后Treg、Treg/Th17均明显高于对照组(P<0.05)。结论中医补肾生血法治疗再生障碍性贫血有明显的临床疗效,可有效提升患者造血功能,提高患者肌体免疫力,其作用机制可能与改善患者免疫细胞水平及相关基因转录因子水平有关。Objective To explore the mechanism of tonifying kidney and generating blood method in the treatment of aplastic anemia.Methods Ninety-eight patients with aplastic anemia admitted from March 2018 to May 2019 were randomly divided into control group and observation group,49 cases in each group.Both groups were given symptomatic supportive treatment such as anti-infection and blood supplement.The control group was given oral treatment of cyclosporine soft capsule,and the observation group was given oral treatment of Bushen Shengxue Decoction.Both groups were treated for 6 months.After treatment,the HGB,WBC,PLT,RET,Ly,serum interleukin,T lymphocyte subsets,Foxp3 mRNA,RORγt mRNA and the levels of Treg and Th17 in peripheral blood immune cells were observed.Results The total effective rate was 97.95%(48/49)in the observation group,which was significantly higher than 83.67%(41/49)in the control group(P<0.05).After treatment,the percentages of WBC,HGB,PLT,RET and Ly in peripheral blood of the observation group were significantly higher than those of the control group(P<0.05).After treatment,the levels of IL-6,IL-17 and IL-23 in the observation group were significantly lower than those in the control group(P<0.05).After treatment,the levels of CD4+and CD4+/CD8+in the observation group were significantly higher than those in the control group(P<0.05).After treatment,Foxp3 mRNA and Foxp3/RORγt in the observation group were significantly higher than those in the control group(P<0.05).Treg and Treg/Th17 in the observation group were significantly higher than those in the control group(P<0.05).Conclusion The tonifying kidney and generating blood method has obvious clinical effect on aplastic anemia.It can effectively improve the hematopoietic function of patients and improve the immunity of patients.The mechanism may be related to improving the levels of immune cells and related gene transcription factors.

关 键 词：再生障碍性贫血 补肾生血法 外周血象 免疫细胞 基因转录因子 

分 类 号：R714.254[医药卫生—妇产科学]