补髓生血汤对慢性再生障碍性贫血患者骨髓基质细胞相关细胞因子的影响

Effect of Busui Shengxue Decoction on Bone Marrow Stromal Cell Related Cytokines in Patients with Chronic Aplastic Anemia

目的:观察补髓生血汤对慢性再生障碍性贫血(CAA)患者的疗效,并探讨其骨髓基质细胞相关细胞因子的机制。方法:随机将2012年3月—2015年10月收治的112例CAA患者分为两组患者,各56例,对照组采用康力龙联合环孢素治疗,观察组基于对照组采用补髓生血汤治疗,观察两组患者疗效,比较治疗前后的临床证候评分,血红蛋白(Hb),白细胞计数(WBC),血小板计数(PLT),骨髓像,碱性成纤维细胞生长因子(b FGF)和b FGF受体(b FGFR)mRNA表达量。结果:观察组总有效率(87.50%)高于对照组(67.86%)(χ~2=6.231,P<0.05);两组患者治疗后的临床证候评分均下降,且观察组低于对照组(P<0.05);观察组治疗后WBC,PLT,Hb升高,且高于对照组(P<0.05);治疗后,观察组骨髓增生程度改善,且优于对照组(P<0.05),观察组的非造血细胞比率(41.68±7.85)%,明显低于对照组的(53.45±8.78)%(P<0.05);两组患者治疗后b FGF,b FGFR表达升高,且观察组高于对照组(P<0.05)。结论:补髓生血汤治疗CAA患者的效果较好,对血象、骨髓象,骨髓造血功能具有改善作用,可能与调节细胞因子b FGF和b FGFR mRNA表达有关。

Objective： To observe the effects of Busui Shengxue decoction on bone marrow stromal cell related cytokines in patients with chronic aplastic anemia（ CAA）,and discuss its mechanism of action. Method：The 112 cases of CAA patients from March 2012 to October 2015 were randomly divided into control group（ 56cases） and observation group（ 56 cases）. Patients in control group received Stanozolol and ciclosporin,and patients in observation group received Busui Shengxue decoction on the basis of treatment in control group. The treatment effects of two groups were observed,and the clinical symptom scores,hemoglobin（ Hb）,white blood cell count（ WBC）, platelet count（ PLT）, bone marrow proliferation degree percentage, the percentage of hematopoietic cells,alkaline fibroblast growth factor（ b FGF） and b FGF receptors（ b FGFR） mRNA expression levels before and after treatment in two groups were compared. Result： The total effective rate was 87. 50% in observation group,higher than 67. 86% in control group（ χ^2= 6. 231,P〈0. 05）. After treatment,the clinical symptom scores were decreased in both groups,and the scores in observation group were lower than those in control group（ P〈0. 05）. After treatment,WBC,PLT,and Hb levels were increased in observation group,and those levels were higher than those in control group（ P〈0. 05）. After treatment,the bone marrow hyperplasia degree and percentage in observation group were improved and better than those in control group（ P〈0. 05）;hematopoietic cells percentage in observation group（ 41. 68 ± 7. 85） %,was significantly lower than that of control group（ 53. 45 ± 8. 78） %（ P〈0. 05）; b FGF and b FGFR expression levels were increased in both groups,and the levels in observation group were significantly higher than those in control group（ P〈0. 05）. Conclusion： Busui Shengxue decoction has better clinical efficacy in treatment of patients with chronic aplastic anemia,which can improve bone marrow hematopoietic function,and the mechanism may be associated with regulating the mRNA expression levels of b FGF and b FGFR.