慢性再生障碍性贫血中西医结合优化治疗方案临床研究

Clinical Study on Optimal Scheme of Chronic Aplastic Anemia Treated with Integrated Therapy of Traditional Chinese and Western Medicine

目的评价补肾方联合雄激素及免疫抑制剂治疗慢性再生障碍性贫血(CAA)的临床疗效,以确立中西医结合治疗CAA的优化治疗方案。方法将39例CAA患者随机分为3组,对照组(16例)采用司坦唑醇片联合环孢素A(CsA),试验一组(11例)辨证采用补肾Ⅰ、Ⅱ、Ⅲ号方治疗,试验二组(12例)在对照组基础上加用补肾Ⅰ、Ⅱ、Ⅲ号方治疗,疗程6个月。分别观察各组临床疗效及治疗前后患者外周血清促红细胞生成素(EPO)、干扰素-γ(IFN-γ)水平的变化情况。结果 3组在临床疗效、外周血象改善方面差异无统计学意义(P>0.05),但试验二组在贫血症状及中医证候的改善方面明显优于另外2组(P<0.05),并能显著降低IFN-γ水平(P<0.05)。结论补肾方联合雄激素及免疫抑制剂治疗CAA在临床疗效、改善症状及提高血常规计数方面均优于单用中药或单用西药治疗。

Objective To evaluate the clinical efficacy of Bushen Formula combined with androgen and immunosuppressive agents in treatment of chronic aplastic anemia（CAA）,and establish the optimal treatment of CAA by integrative medicine.Methods Thirty-nine patients with CAA were randomly divided into three groups.The control group（16 cases） was treated by stanozolo and cyclosporin A.Test group Ⅰ（11 cases） was treated by Bushen formula Ⅰ,Ⅱ,Ⅲ according to syndrome differentiation.Test group Ⅱ（12 cases） was treated by Bushen formula Ⅰ,Ⅱ,Ⅲ combined with the western medicines in the control group.After treated for 6 months,the clinical effects of each group,and the changes of EPO and IFN-γ levels in serum were observed.Results In terms of clinical therapeutic effects and effects indicated by peripheral blood routine examination,no significant difference existed among test group Ⅰ,test group Ⅱ and control group（P〉0.05）.While anemia and syndromes in the test group Ⅱ was improved significantly than that in the other two groups（P〈0.05）,IFN-γ levels of test group Ⅱ decreased significantly（P〈0.05）.Conclusion Bushen Formula combined with androgen and immunosuppressive agents is superior to simple Chinese medicine or western medicine in treating aplastic anemia on aspects of clinical efficacy,improvement of anemia and blood rountine.