补肾生血法治疗慢性再障的临床观察及对ICAM-1表达的影响研究  

Clinical Observation of Tonifying Kidney and Producing Blood Therapy in Treatment of Chronic Aplastic Anemia and Its Influence to ICAM-1 Expression

作　　者：王金环[1] 谷梦宇 于孙婉琪 牛丁忍 孙岸弢[4] 代月 WANG Jinhuan;GU Mengyu;YU Sunwanqi;NIU Dingren;SUN Antao;DAI Yue(The First Affiliated Hospital of Heilongjiang University of Chinese Medicine, Harbin 150040, China;Heilongjiang University of Chinese Medicine, Harbin 150040, China;Anhui University of Chinese Medicine, Hefei 2300, China;Guang’anmen Hospital, Chinese Academy of Chinese Medical Sciences, Beijing 100000, China)

机构地区：[1]黑龙江中医药大学附属第一医院,黑龙江哈尔滨150040 [2]黑龙江中医药大学,黑龙江哈尔滨150040 [3]安徽中医药大学,安徽合肥230012 [4]中国中医科学院广安门医院,北京100053

出　　处：《中医药学报》2022年第4期41-45,共5页Acta Chinese Medicine and Pharmacology

基　　金：国家自然科学基金项目(81673968);黑龙江省博士后科研基金(LBH-Q14153);黑龙江中医药大学校科研基金(2019TD03)。

摘　　要：目的:观察使用补髓生血颗粒治疗慢性再障的临床疗效,及其对细胞间黏附分子ICAM-1表达的影响,探讨补髓生血颗粒对慢性再障的作用机制和疗效机理。方法:选取55例慢性再障患者纳入治疗组,并分为肾阴虚型与肾阳虚型,对症基础治疗并口服补髓生血颗粒6个月,观察其治疗前后的外周血变化情况、中医证候积分,进行疗效判定与剖析;选取20例健康志愿者纳入对照组。使用ELISA法测定治疗组与对照组外周血血清中的ICAM-1表达水平。结果:使用补髓生血颗粒治疗6个月后,治疗组外周血血象有所提升(P<0.05),中医证候积分较治疗前有所下降,有效率达90%(45/50);治疗组治疗前的外周血黏附分子ICAM-1表达水平低于对照组;治疗后有所提升,但仍低于健康对照组(P<0.05);肾阴虚型中医证候积分改善水平、外周血HGB提高水平、外周血ICAM-1提高水平均低于肾阳虚型(P<0.05)。结论:补肾生血法治疗慢性再障疗效明显,并可提高外周血黏附分子ICAM-1的表达水平,肾阳虚型优于肾阴虚型;提示慢性再障的发病机制可能与ICAM-1的异常表达相关,补髓生血颗粒可通过改善造血微环境方面来恢复慢性再障患者的造血功能。Objective:To observe the clinical effect of Busui Shengxue Granule in the treatment of chronic aplastic anemia(AA),and its influence to ICAM-1 expression of intercellular adhesion molecules,thus to explore its action mechanism.Methods:55 patients with chronic AA were selected into the treatment group and divided into Kidney-Yin deficiency and Kidney-Yang deficiency,and they were treated with symptomatic basic intervention and oral Busui Shengxue Granule for 6 months.20 healthy volunteers were selected into the control group.Peripheral blood and TCM syndrome score were observed before and after the treatment to evaluate efficacy.The expression level of ICAM-1 in peripheral blood was determined by ELISA method in the two groups.Results:After 6 months of treatment with Buisui Shengxue Granule,the peripheral blood indexes were improved in the treatment group(P<0.05),and the TCM syndrome score was decreased(P<0.05).The total effective rate of the treatment group was 90%(45/50).The expression of peripheral blood adhesion molecule ICAM-1 was lower in the treatment group than that in the control group before the treatment;which was increased after the treatment,but was still lower than that in the control group(P<0.05).The improvements of TCM syndrome score,peripheral blood HGB and peripheral blood ICAM-1 were lower in the Kidney-Yin deficiency group than those in the Kidney-Yang deficiency group(P<0.05).Conclusion:Tonifying Kidney and producing blood therapy can improve the expression of peripheral blood adhesion molecule ICAM-1 in the treatment of chronic AA,which is better for Kidney-Yang deficiency pattern than Kidney-Yin deficiency pattern.The pathogenesis of chronic AA may be related to abnormal expression of ICAM-1,and Buisui Shengxue Granule can restore hematopoietic function by improving hematopoietic microenvironment.

关 键 词：再生障碍性贫血 补肾生血 贫血 

分 类 号：R285.6[医药卫生—中药学]