补肾活血方治疗慢性再生障碍性贫血合并铁过载的临床疗效观察  

Clinical observation on Bushen Huoxue Formula for treatment of chronic aplastic anemia patients with iron overload

作　　者：刘文宾[1] 沈晓玲 俞颖[1] 胡慧瑾[1] 赵越超 吴迪炯[2] 叶宝东[1] LIU Wen-bin;SHEN Xiao-ling;YU Ying;HU Hui-jin;ZHAO Yue-chao;WU Di-jiong;YE Bao-dong(The First Hospital Affiliated to Zhejiang Chinese Medical University,Hangzhou 310006,China)

机构地区：[1]浙江中医药大学附属第一医院,杭州310006 [2]浙江中医药大学附属第一医院血液科

出　　处：《中华中医药杂志》2022年第3期1822-1825,共4页China Journal of Traditional Chinese Medicine and Pharmacy

基　　金：国家中医药管理局国家中医临床研究基地业务建设科研专项(No.JDZX2015118);浙江省中医药管理局基金项目(No.2017ZB034,No.2020ZB096);浙江中医药大学校级科研基金项目(No.2019ZG06)。

摘　　要：目的:评价补肾活血方治疗慢性再生障碍性贫血(CAA)合并铁过载患者的祛铁疗效及机制。方法:选取2015年2月至2016年12月在浙江中医药大学附属第一医院血液科门诊和病房就诊的CAA合并铁过载患者115例,分为西药对照组30例、补肾活血组69例和西药祛铁组16例。西药对照组予西医基础治疗,补肾活血组予西医基础治疗和补肾活血方口服治疗,西药祛铁组予西医基础治疗和西药祛铁治疗。治疗3个月后比较各组的临床疗效以及治疗前后血清白细胞介素(IL)-2、IL-6、IL-10、干扰素-γ(IFN-γ)、肿瘤坏死因子-α(TNF-α)表达水平。结果:补肾活血组治疗后血红蛋白水平、血小板计数均较治疗前显著升高(P<0.05);且血红蛋白水平显著高于西药对照组(P<0.05);补肾活血组祛铁疗效总有效率达23.19%(16/69),治疗前后血清铁蛋白水平差异无统计学意义;补肾活血组治疗后IL-6、IL-10水平较治疗前显著下降(P<0.05),且显著低于西药对照组及西药祛铁组(P<0.05)。结论:补肾活血方可能通过降低IL-6、IL-10表达促进CAA患者对铁的体内调控,促进骨髓造血恢复。Objective: To evaluated the efficacy and pathogenesis about Bushen Huoxue Formula for treatment of chronic aplastic anemia(CAA) patients with iron overload. Methods: From February 2015 to December 2016 in The First Hospital Affiliated to Zhejiang Chinese Medical University inpatient and outpatient, 115 enrolled patients were divided into control group of western medicine(30 patients), tonifying kidney and activating blood group(69 patients) and iron chelation group(16 patients). The clinical efficacy and the expression levels of serum IL-2, IL-6, IL-10, IFN-γ, TNF-α of each group were compared before and after 3 months treatment. Results: The patients of tonifying kidney and activating blood group elevated the levels of hemoglobin and platelet after treatment(P<0.05) and the level of hemoglobin was significantly higher compared with the western medicine control group(P<0.05);The response rate of dispelling iron in tonifying kidney and activating blood group was 23.19%(16/69) after treatment, but there was no statistical difference about serum ferritin levels before and after treatment;After treatment, the levels of serum IL-6, IL-10 were significantly decreased in tonifying kidney and activating blood group(P<0.05),meanwhile, it was significantly decreased than the other groups(P<0.05). Conclusion: Bushen Huoxue Formula may promote the regulation of iron in vivo patients with CAA by reducing the expression of IL-6, IL-10 and promote the recovery of bone marrow hematopoiesis.

关 键 词：补肾活血方 铁过载 慢性再生障碍性贫血 

分 类 号：R259[医药卫生—中西医结合]