中药联合自体造血干细胞移植治疗难治性重症自身免疫病的临床观察

Treatment of Refractory Severe Autoimmune Disease by Combined Therapy with Chinese Drug and Autohemopoietic Stem Cell Transplantation

目的探讨中药联合造血干细胞移植治疗难治性重症自身免疫病的临床疗效。方法对7例难治性重症自身免疫性疾病患者[其中系统性红斑狼疮(SLE)4例,重症肌无力(MG)2例,多发性肌炎(PM)1例]进行自体造血干细胞移植。预处理采用FAC方案:氟达拉滨、抗胸腺细胞球蛋白和环磷酰胺。移植后根据患者情况进行中医辨证论治给予中药口服。结果所有患者造血功能均顺利重建,临床症状体征改善显著,实验室疾病指标转阴或显著下降,所用药物减量或停药。结论中药联合造血干细胞移植可使难治性重症自身免疫性疾病患者造血功能得到较快重建,并发症减少,临床症状体征改善,效果显著。

Objective To investigate the clinical effect of Chinese herbal medicine combined with auto-hemopoietic stem cell transplantation for refractory severe autoimmune disease （RSAID）. Methods Auto-hemopoietic stem cell transplantation was conducted for the treatment of 7 patients with RSAID, including 4 cases of systemic lupus erythematosus （SLE）, 2 myasthenia gravis （MG） and 1 polymyositis （PM） with the FAC program （consisting of fludarabine, antithymocyte globulin, and cyclophosphamide FAC） as for pretreatment. Traditional Chinese medicine （TCM） was given orally after transplantation to patients according to their syndrome type. Results The hemopoiesis function was smoothly re-established in all patients, with their clinical symptoms and signs obviously improved, laboratory indexes negatively conversed or obviously decreased, and withdrawal or dose reducing of medicines. Conclusion Combined use of TCM after auto-hemopoietic stem cell transplantation can accelerate patients＇ hemopoiesis function re-establishment, with significant effects in reducing complications, improving clinical symptoms and signs.