温肾益髓法治疗肾阳虚型再生障碍性贫血的疗效观察及对Th1/Th2及细胞因子的影响

Clinical Observation of Wenshen Yisui Method for Kidney-Yang Deficiency Aplastic Anemia and its Effect on Th1/Th2 and Cell Factor

目的:观察温肾益髓法治疗肾阳虚型再生障碍性贫血(AA)的临床疗效,及对Th1/Th2和细胞因子的影响。方法:将符合要求的40例AA患者随机分为治疗组和对照组各20例,治疗组予中药联合西药治疗,对照组单用西药治疗。疗程均为6个月,观察2组临床疗效及治疗前后外周血细胞计数、Th1/Th2和细胞因子的变化。结果:治疗组临床疗效优于对照组,差异有统计学意义(P<0.05);治疗组治疗后红细胞计数、血红蛋白含量均高于对照组,差异有统计学意义(P<0.05,P<0.01);与治疗前比较,治疗组CD4+IFN-γ+细胞/CD4+细胞比例降低,差异有统计学意义(P<0.01);TNF-α、IFN-γ较治疗前均明显降低,差异有统计学意义(P<0.05);与对照组比较,IFN-γ降低明显,差异有统计学意义(P<0.01)。结论:温肾益髓中药可提高肾阳虚型AA的治疗效果,其作用机制可能与减少Th1细胞的数量,调节Th1/Th2平衡,减少造血负调控因子TNF-α、IFN-γ的分泌有关。

Objective： To observe the clinical efficacy of Wenshen Yisui Method for treating kidney-Yang deficiency aplastic anemia （AA） and its effect on Thl/Th2 and cell factor. Methods： 40 AA patients met the requirement were randomly divided in- to 2 groups, 20 cases in each one. One （ treatment group） treated with Chinese and Western medicine, the other （ controlled group） treated with only western medicine. The treatment lasted for 6 months. The blood cell counts, Th1/Th2 and cell factor changes before and after treatment in the two groups were observed. Results ： The total effective rate of the treatment group was higher than the controlled group, and the two results had difference （P 〈 0. 05 ）. After treatment, the red blood cell count and hemoglobin of treatment group were higher than before, with statistical significance （ P 〈 0.05, P 〈 0. 01 ）. After treatment, The ratio of CD4^＋IFN-γ cell/CD4^＋ cell in the treatment group were lower than before （P 〈 0. 05 ）. After treatment, The TNF-α, IFN-γ were decreased more than before, among them, IFN-γ was decreased more than those of the controlled group （ P 〈 0. 05 ）. Conclusidn ： Wenshen Yisui Method can improve treatment efficacy for AA. The mechanism may be related to the decrease of Thl cells, regulate the balance of Th1/Th2, and decrease TNF-αand IFN-γexudation.