【作者】 邹长鹏；

【导师】 孙伟正；

【作者基本信息】 黑龙江中医药大学 ， 中医内科学， 2006， 硕士

【摘要】 目的:探讨补髓生血颗粒治疗慢性再生障碍性贫血(CAA)患者的临床疗效及其对患者血清肿瘤坏死因子-α(TNF-α)水平的影响,从而揭示补髓生血颗粒的临床疗效机理。 方法:本研究将入选的68例CAA病人以开放式半随机分为治疗组和对照组,其中治疗组35例,对照组33例(脱落2例)。治疗组给予补髓生血颗粒,对照组给予再障生血片,疗程3个月,2个疗程后观察疗效,并对CAA患者治疗前后血象、骨髓象进行对比分析。采用ELISA法检测CAA患者治疗前后血清TNF-α表达水平的变化。 结果:1.补髓生血颗粒治疗CAA总有效率74.29%,优于再障生血片(总有效率48.48%)。肾阳虚型疗效优于肾阴虚型(有效率分别为93.75%和57.89%);2.CAA患者血清TNF-α水平在治疗前高于正常组,治疗后治疗组和对照组均有所降低,并且治疗组的下降程度优于对照组,肾阳虚型组下降程度优于肾阴虚型组,但与正常组比较仍有显著差异。 结论:1.补髓生血颗粒治疗CAA的临床疗效优于再障生血片(p<0.05)。治疗组中肾阳虚型疗效优于阴虚型(p<0.05),CAA中存在阳虚易治、阴虚难调的疗效差异现象;2.CAA患者血清TNF-α水平异常升高;3.通过调节TNF-α表达水平来改善CAA的骨髓造血功能可能是补髓生血颗粒治疗CAA的疗效机理之一;4.补髓生血颗粒是防治CAA的有效药物,值得进一步研究和开发。更多还原

【Abstract】 Objective: To study the clinical effect and observe the difference of the expression level of serum TNF- α of patients with CAA before and after treatment, reveal the pathogenesis of CAA and and effect mechanism of Busui Shengxue Granule (BSSXG) on CAA.Method: The clinical trial was performed in open label study. Sixty patients who were taken into account were divided into experiment group and control group. Thirty patients in experiment group were treated with BSSXG, and the twenty-eight patients, two patients lost, in control group were treated with AABET (Aplastic Anemia Blood engendering Tablet ). Three months was described as one period of treatment. After two periods, clinical effect was observed and the change of hemogram, myelogram were analyze. Also, this experiment employed ELISA method to exam the change of expression level of serum TNF- α before and after treatment.RESULT: 1.The total effective rate of BSSXG and AABET were 74.29% and 48.48%. The curative effect in Yang deficiency type was superior to that in Yin deficiency type (P<0.05), and the total effective rate are 93.75% and 57.89% respectively. 2. The expression of TNF- α in the serum of CAA patients was higher than that in normal group and reduced after treatment. Moreover, the descent in experiment group was superior to that in control group, and the descent in Yin deficiency group was superior to that in Yang deficiency group. After treatment there was no significant difference in TNF- α expression level between experiment group and control group.Conclusion: l.The effect of BSSXG group was superior to that of AABET group (P<0.05). In BSSXG group, its curative effect wassuperior in Yang deficiency type to that in Yin deficiency type.This experiment testified the phenomenon of "Yin deficiency is easy to cure, but Yang deficiency is difficult to treat." 2. The expression of TNF- a in the serum of CAA patients was higher than that in normal group and cutted down after treatment. 3. BSSXG probably adjust the expression of TNF-a to improve hematopoiesis in bone marrow. 4. BSSXG is an effective drug to treat CAA, which is worthy of further study and development.更多还原