中医药治疗骨髓增生异常综合征概况

The Advance of TCM in Myelodysplastic Syndromes

骨髓增生异常综合征MDS(IL)-2缺乏、活性明显降低,(SIL-2R)活性增强,高度表达肿瘤坏死因子(TNF-Α)、干扰素(INF-Γ);体外培养发现间质细胞和巨噬细胞产生肿瘤坏死因子(TNF-Α)和白细胞介素6高于正常人,血浆IL-10高于正常人,与CD3+、CD8+细胞百分比正相关,与CD4+细胞负相关。2008年常见血液病中医病名专题讨论会,正式命名为"髓毒劳","髓"代表病位,"毒"代表病性,"劳"代表病状。病性为"本虚标实"和"正虚邪实",贯穿整个疾病过程。整体观念,经典方剂、自拟方、辨证分型治疗,补气养血治疗以改善外周血中血红蛋白及血小板指标为主,对骨髓作用以改善红系造血为主,左归丸或右归丸加减为阴阳双补,调节免疫群体,解毒药物明显增加白细胞,改善骨髓病态造血疗效满意,对免疫学及遗传学指标改善及疗效评价有重要意义。青黄散加减适应广泛。辨证分型治疗MDS强调个体差异性,疗效不同,目前尚无明确最优治疗方案。不同方药疗效差异颇大,危险分层、中医证型特点、染色体差异、年龄分层、男女性别及体质差异、病程长短与证型关系,需要更多大样本、广地域临床研究,完善MDS辨证分型、选择标准、治则方药、规范治疗方案。

Bone marrow hyperplasia anomaly syndrome MDS（IL）-2 lack, activity decreased significantly, s IL-2R） activity was enhanced, and is highly expressed tumor necrosis factor（TNF alpha） and interferon（INF gamma）; observed in vitro cultured stromal cells and macrophages produce tumor necrosis factor（TNF alpha） and white blood cell） is higher than that of normal people, plasma IL-10 is higher than that of normal people, and CD3^＋, CD8^＋T cell percentage of the positive correlation, and CD4^＋ cell negative correlation. In 2008 in the common blood disease in TCM disease name symposium, officially named ＂Sui Du Lao＂, ＂Sui＂ on behalf of the disease, ＂poison＂ on behalf of the disease, ＂work＂ on behalf of the pathologies. The disease is ＂the deficiency of the real＂ and ＂is false evil＂, through the whole process of the disease. The overall concept and classical prescriptions, self-made, syndrome differentiation, divided into treatment, Qi and blood treatment to improve the peripheral blood hemoglobin and platelet index, on the role of bone marrow to improve erythropoiesis mainly, Zuogui pill and Yougui Pill for tonifying Yin and Yang, regulating immune population and solution of drugs increased leukocyte, improve the bone marrow hematopoiesis of satisfactory, on immunology and genetic index improvement and efficacy evaluation is important. Huang San to wide. Syndrome differentiation and treatment of MDS stressed individual differences, the effect is different, there is no clear optimal treatment plan. Different curative effect quite big difference, risk stratification, TCM syndrome type, chromosome differences, stratification by age, gender and physical differences, duration of disease and syndrome type and need to more samples, regional wide clinical study, consummate type, selection criteria and treatment prescription, standard regimen in the treatment of syndrome differentiation of MDS.