清开灵对急性再生障碍性贫血患者T细胞亚群的影响

Effect of Qingkailing Injection on the T lymphocyte subsets of acute aplastic anemia patients

目的观察清开灵对急性再生障碍性贫血患者T细胞亚群的影响,并探讨其作用机制。方法将59例急性再生障碍性贫血患者随机分为2组。对照组29例用康力龙,每次2～4mg,每日3次口服;环胞素3mg/(kg·d)口服。治疗组30例在对照组治疗基础上加用清开灵10～20mL,日1次静脉滴注,连用15d,休息15d,休息期间予清开灵颗粒1.5g,每日2次口服。2组均30d为1个疗程,6个疗程后统计临床疗效、死亡率,并检测外周血T细胞亚群水平。结果治疗组总有效率、死亡率分别为73.3%、6.7%,对照组总有效率、死亡率分别为48.3%、20.7%,2组比较差异均有统计学意义(P<0.01)。2组治疗前外周血CD8高于正常,CD4/CD8比值低于正常,治疗后CD8下降,CD4/CD8比值升高与治疗前比较差异均有统计学意义(P<0.01),且治疗组治疗后CD8的下降程度和CD4/CD8比值升高程度与对照组比较差异均有统计学意义(P<0.01,P<0.05)。临床症状及血象改善时间治疗组较对照组短,2组比较差异有统计学意义(P<0.01)。结论清开灵辅助治疗急性再生障碍性贫血疗效确切,毒副反应少,其作用机制可能是通过调节机体免疫功能从而阻止急性再生障碍性贫血患者造血细胞的过度凋亡。

Objective To Observe the effect of Qingkailing Injection on the T lymphocyte subsets of acute aplastic anemia patients and explore its mechanism. Methods Fifty nine cases with acute aplastic anemia were randomly divided into two groups： control group and treatment group . twenty nine cases in control group were given 2 - 4 mg of Stanozolol three times a day by mouth, Cyclosporine A 3mg/kg/d. On the basis of control group, treatment group were given Qingkailing Injection10 - 20 mL once every day for fifteen days , then with the interval of 15 days （Qingkaihng granules were taken in these days）, a course of treatment was 30 days. After a period of 6 courses, the clinical efficacy, mortality rate and levels of T lymphocyte subsets in peripheral blood were analyzed. Results Total effective rate and mortality rate in the treatment group was 73.3%, 6.7% respectively. Total effective rate and mortality rate in the control group was 48.3% ,20. 7%respectively. The difference between control group and treatment group had statistical significance（ P 〈 0.01）. In each group level of CD8 ＋ cells in peripheral blood was beyond normal , ratio of CD4/ CD8 was lower than normal before treatment.level of CD8 ＋ cells decreased and ratio of CD4/CD8 increased after treatment. There were significant differences in each group pre and post treatment. Furthermore, compared with control group level of CD8 ＋ Lymphocyte and Ratio of CD4/ CD8 had signifcant difference （ P 〈 0,01, P 〈 0.05）after treatment. Improvement time of clinical symptoms and haemogram in treatment group were shortened with statistical significance as compared with the control group. Conclusions Qingkailing Injection is of obvious curative effect and less side effect in treating acute aplastic anemia, regulating immune function and inhibitting excessive apoptosis of hematopoietic cells may be one of the mechanisms of Qingkailing Injection in treating acute aplastic anemia.