【摘要】 目的观察复方参鹿颗粒联合西药治疗肾阳虚型再生障碍性贫血(简称再障)的临床疗效,探讨其作用机制。方法将60例肾阳虚型再障患者随机分为治疗组和对照组,每组30例。治疗组予复方参鹿颗粒联合常规西药治疗,对照组单用常规西药治疗。两组疗程均为6个月、随访6个月,观察临床疗效,比较外周血免疫细胞Treg、Th17的表达水平,以及相关基因转录因子孤独核受体γt(RORγt)、叉状转录因子(Foxp3)mRNA的表达情况。结果①治疗组、对照组临床总有效率分别为76.67%、63.33%;组间临床疗效比较,治疗组明显优于对照组(P<0.05)。②组间治疗后比较,Th17表达水平差异无统计学意义(P>0.05),而Treg表达及Treg/Th17水平差异有统计学意义,治疗组明显高于对照组(P<0.05)。③组间治疗后比较,RORγt mRNA表达水平差异无统计学意义(P>0.05),而Foxp3 mRNA表达及Foxp3/RORγt水平差异有统计学意义,治疗组明显高于对照组(P<0.05)。结论复方参鹿颗粒联合西药,可明显改善再障患者临床症状,提升机体造血功能,其机制可能与上调Treg细胞及其相关基因转录因子Foxp3 mRNA的表达,调整Treg/Th17的比值有关。更多还原

【Abstract】 Objective To observe the clinical efficacy of Compound Shenlu Granule combined with western medicine in the treatment of aplastic anemia( AA) with syndrome of kidney yang deficiency,and discuss its mechanism. Methods Sixty AA patients with syndrome of kidney yang deficiency were randomly divided into the treatment group and control group,30 cases in each group. The treatment group was treated with Compound Shenlu Granule combined with routine therapy of western medicine,while the control group was only treated with routine therapy of western medicine. The treatment course in both groups was 6 months with followup for one year. The clinical efficacy was observed,and the expression levels of Treg and Th17 in peripheral blood and the mRNA expressions of related gene transcription factors including retinoid related orphan nuclear receptor γt( RORγt) and forkhead transcription factor( Foxp3) were compared. Results(1) The clinical total effective rate was 76. 67% in the treatment group and 63. 33% in the control group. The clinical efficacy of treatment group was significantly better than that of control group( P < 0. 05).(2)After treatment,there was no statistically significant difference on the expression level of Th17 between the two groups( P> 0. 05),while there were statistically significant differences on the Treg expression and Treg/Th17 level between the two groups,and the levels of the treatment group were obviously higher than those of the control group( P < 0. 05).(3)After treatment,there was no statistically significant difference on the RORγt mRNA expression between the two groups( P > 0. 05),while there were statistically significant differences on Foxp3 mRNA expression and the Foxp3/RORγt level between the two groups,and the levels of the treatment group were obviously higher than those of the control group( P < 0. 05). Conclusion Compound Shenlu Granule combined with western medicine can significantly improve the clinical symptoms of AA patients,and enhance the hematopoietic function. Its mechanism may be associated with up-regulation of Treg cells and Foxp3 mRNA expression and increase of Treg/Th17 ratio.更多还原