【作者】 王琰；

【导师】 徐瑞荣；

【作者基本信息】 山东中医药大学 ， 中西医结合临床， 2006， 硕士

【摘要】 目的:观察补肾方对慢性再障患者造血调控因子的调节作用,探讨补肾中药的调节机制。方法:将符合纳入标准的65例慢性再障患者随机分为治疗组35例(其中肾阳虚组9例、肾阴虚组14例、肾阴阳两虚组12例),对照组30例。治疗组给予补肾Ⅰ、Ⅱ、Ⅲ号方+康力龙,对照组给予康力龙,治疗6个月。观察两组治疗疗效。并收集各组患者治疗前后的骨髓培养上清和骨髓单个核细胞。另取健康人骨髓10例作为正常对照。通过ELISA法及RT-PCR法分别观察其骨髓造血细胞生长因子EPO、SCF、GM-CSF的分泌水平及其mRNA半定量表达情况。结果:(1)治疗组治疗慢性再障总有效率80%,较之对照组56.67%有显著性差异(P<0.05)。补肾方药可升高慢性再障患者的WBC、Hb、PLT,改善骨髓造血情况,明显改善临床症状。(2)慢性再障患者体内EPO、SCF、GM-CSF分泌水平明显低于正常组(P<0.01),治疗后患者体内EPO、SCF、GM-CSF水平明显升高。在治疗效果上,肾阳虚型患者优于肾阴虚型患者。结论:慢性再障患者存在造血调控因子介导的免疫紊乱的病理机制。补肾中药可调节紊乱的免疫状态,升高造血调控因子EPO、SCF、GM-CSF的水平。其取得临床疗效的机制可能与调控造血细胞因子分泌水平有关。更多还原

【Abstract】 Objective: To observe how Bushen formula to regulate hematopoiesis regulation factors of chronic aplastic anemia patients,and discuss the regulation mechanism of kidney promote herbs. Methods: 65 patients with chronic aplastic anemia were randomly divided into two groups.The treatment group(35 cases, including 9 cases of kidney-Yang deficiency、14 cases of kidney-Yin deficiency、12 cases of kidney-Yin and Yang deficiency) was treated with Bushen formulaⅠ、Ⅱ、Ⅲcombined with Stanozolol and the control group(30 cases) was treated with Stanozolol for 6 months. The clinical effect were observed during the course. Bone marrow cultivated upper clear fluid and bone marrow monocyte of all patients before and after therapy were collected.Besides these 10 cases of healthy bone marrow were collected as normal controls. Hematopoiesis regulation factors such as EPO、SCF、GM-CSF and mRNA semi-quantitative expression were observed by ELISA and RT-PCR. Results:(1) The total effective rate of the treatment group reaches 80%, while the control group reaching 56.67%, which shows significantly difference between them(P<0.05). Kidney promote herbs can enhance WBC、Hb、PLT of chronic aplastic anemia patients,improve bone hematopoiesis and clinical manifestations markedly.(2) The level of EPO、SCF、GM-CSF in chronic aplastic anemia patients was lower obviously than normal controls(P<0.01),which increased evidently after therapy. Kidney-Yang deficient patients precede kidney-Yin on curative effects.Conclusion: The disorder of immunity mechanism on hematopoiesis regulation factors was one of the pathology mechanism with chronic aplastic anemia patients. Kidney promote herbs can regulate the disorders of immunity.The level of GM-CSF、EPO、SCF increased after therapy.Maybe the mechanism of curative effect was concerned with the regulation of hematopoiesis cytokine.更多还原