【摘要】 目的 探讨参芪仙补汤治疗气阴两虚型较低危骨髓增生异常综合征(LR-MDS)的临床疗效及其对免疫和炎症指标的影响。方法 将110例气阴两虚型LR-MDS患者随机分为观察组(55例)和对照组(55例)。对照组给予司坦唑醇片及支持治疗，观察组在对照组基础上联合参芪仙补汤口服，治疗周期均为12周。比较2组患者治疗前后中医证候积分、血常规指标、输血频次、Treg/Th17免疫指标、炎症因子水平、血液学改善疗效、总体治疗效果及不良反应发生情况。结果 治疗后，2组患者的中医证候积分、IL-17水平均降低(P<0.05)，观察组优于对照组(P<0.05)。2组患者的RBC、WBC、Hb、Ret、Treg、Treg/Th17比值、IL-4、IL-10、TGF-β水平均升高(P<0.05)，观察组优于对照组(P<0.05)。观察组输血频次低于对照组(P<0.05)。观察组HI-E总有效率、总体治疗效果均优于对照组(P<0.05)。2组不良反应发生率比较差异无统计学意义(P>0.05)。结论 参芪仙补汤能有效改善气阴两虚型LR-MDS患者的临床症状，改善Treg/Th17免疫平衡状态，降低炎症水平，提高临床预后。更多还原

【Abstract】 Objective To investigate the clinical efficacy of Shenqi Xianbu Decoction in the treatment of lower-risk myelodysplastic syndrome (LR-MDS) with the pattern of deficiency of both qi and yin and its effects on immune and inflammatory indicators.Methods A total of 110 LR-MDS patients with the pattern of deficiency of both qi and yin were randomly divided into an observation group (n=55) and a control group (n=55).The control group received stanozolol and supportive treatment,while the observation group received Shenqi Xianbu Decoction orally in addition to the control group.The treatment cycle was 12 weeks for both groups.The traditional Chinese medicine (TCM) syndrome scores,blood routine indexes,transfusion frequency,Treg/Th17 immune indicators,inflammatory cytokine levels,hematological improvement e?cacy,overall treatment e?cacy,and adverse reactions were compared between the two groups before and after treatment.Results After treatment,the TCM syndrome scores and IL-17 level were decreased in both groups (P<0.05),with the observation group showing a more significant reduction than the control group (P<0.05).The levels of RBC,WBC,Hb,Ret,Treg,Treg/Th17 ratio,IL-4,IL-10,and TGF-β were increased in both groups (P<0.05),with the observation group exhibiting greater improvement than the control group (P<0.05).The observation group had a lower transfusion frequency compared to the control group (P<0.05).The overall response rate of HI-E and overall treatment effectiveness were significantly higher in the observation group than those in the control group,respectively (P<0.05).No significant difference was observed in the incidence of adverse reactions between the two groups (P>0.05).Conclusion Shenqi Xianbu Decoction can effectively improve the clinical symptoms in LR-MDS patients with the pattern of deficiency of both qi and yin,ameliorate Treg/Th17 immune imbalance,reduce inflammation,and improve clinical prognosis.更多还原