基于iRhom2/ADAM17信号通路探讨益气活血方治疗出血性血小板病患者的作用机制  

Based on iRhom2/ADAM17 Signal Pathway to Explore the Mechanism of Yiqi Huoxue Formula for Treating Hemorrhagic Thrombopathy

作　　者：卢芙蓉 秦铀 沈霖[1] 帅波 马陈 徐晓娟 廖奕[1] 杨艳萍[1] LU Furong;QIN You;SHEN Lin;SHUAI Bo;MA Chen;XU Xiaojuan;LIAO Yi;YANG Yanping(Department of Integrated Traditional Chinese and Western Medicine,Union Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430022,China;Cancer Center,Union Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430022,China)

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,武汉430022 [2]华中科技大学同济医学院附属协和医院肿瘤中心,武汉430022

出　　处：《中西医结合研究》2020年第4期217-221,共5页Research of Integrated Traditional Chinese and Western Medicine

基　　金：国家自然科学基金资助项目(No.81673761,No.81573765)。

摘　　要：目的观察益气活血方治疗出血性血小板病患者的临床疗效,基于iRhom2/ADAM17信号通路探讨其作用机制。方法选取100例出血性血小板病患者随机分为中药组与西药组,另选50例健康者作为正常对照组。中药组50例采用益气活血方治疗,西药组50例采用肾上腺色腙片治疗。治疗8周后,比较2组患者治疗后的止血疗效及血小板聚集恢复率;比较2组患者治疗前后及正常对照组的血浆非活性的菱形蛋白(iRhom)2、解离素金属酶(ADAM)17和pro-ADAM17蛋白表达水平。结果中药组患者止血疗效为84.78%,显著高于西药组的44.68%(P<0.05)。中药组患者血小板聚集率恢复率为71.74%,显著高于西药组的6.38%(P<0.05)。治疗前,中药组与西药组患者iRhom2与ADAM17蛋白表达水平明显高于正常对照组(P<0.05)。治疗8周后,中药组iRhom2与ADAM17蛋白表达水平较治疗前明显下降,且中药组显著低于西药组(P<0.05)。结论采用益气活血方治疗出血性血小板病患者可显著改善血小板聚集、提升止血效率。iRhom2/ADAM17信号通路参与了出血性血小板病的病理过程,调控iRhom2/ADAM17信号通路可能是益气活血方治疗出血性血小板病的作用靶点之一。Objective To observe the clinical efficacy of Yiqi Huoxue formula in treating patients with hemorrhagic thrombopathy,and to explore its mechanism based on iRhom2/ADAM17 signaling pathway.Methods One hundred patients with hemorrhagic thrombopathy were randomly divided into traditional Chinese medicine group and western medicine group,and 50 healthy people were selected as normal control group.Patients in the traditional Chinese medicine group were treated with Yiqi Huoxue formula,and the western medicine group were treated with carbazochrome tablets.After 8 weeks of treatment,the hemostatic efficacy and platelet aggregation recovery rate were compared in two groups.The levels of plasma inactive rhomboid-like protein(iRhom)2,a disintegrin and metalloproteinase(ADAM)17 and pro-ADAM17 protein expression were compared in two groups before and after treatment and the normal control group.Results The hemostatic efficacy in the traditional Chinese medicine group was 84.78%,which was significantly higher than that in the western medicine group(44.68%)(P<0.05).The platelet aggregation recovery rate in the traditional Chinese medicine group was 71.74%,which was significantly higher than that in the western medicine group(6.38%)(P<0.05).Before treatment,the levels of iRhom2 and ADAM17 protein expression in the traditional Chinese medicine group and the western medicine group were significantly higher than those in the normal control group(P<0.05).After 8 weeks of treatment,the levels of iRhom2 and ADAM17 protein expression in the traditional Chinese medicine group and the western medicine group decreased significantly,and the traditional Chinese medicine group were significantly lower than those in the western medicine group(P<0.05).Conclusion Treating the hemorrhagic thrombopathy patients with Yiqi Huoxue formula could significantly improve platelet aggregation and increase hemostatic efficiency.The iRhom2/ADAM17 signaling pathway was involved in the pathological process of hemorrhagic thrombopathy,and regulating iRhom2/ADA

关 键 词：出血性血小板病 解离素金属酶17 非活性的菱形蛋白2 益气活血方 

分 类 号：R558[医药卫生—血液循环系统疾病]