参萸补血方对脾肾阳虚型慢性再生障碍性贫血患者疗效及其免疫学机制的研究

Research of Shenyu Buxue Formula on Clinical Effect and Immunological Mechanism for Patients suffering from Chronic Aplastic Anemia of Spleen and Kidney Yang Deficiency

目的:研究参萸补血方治疗脾肾阳虚型慢性再生障碍性贫血(Chronic Aplastic Anemia,CAA)患者的疗效及其免疫学机制。方法:入选120例脾肾阳虚型CAA患者,随机分成观察组和对照组各60例。两组均给予常规抗感染、止血、输血等对症支持治疗,在常规治疗基础上,对照组予强的松(0.5 mg·kg^(-1)·d^(-1)),观察组予参萸补血方,每日1剂,分2次口服。两组治疗1个月为1个疗程,共治疗3个疗程,于治疗前、治疗3个月后行血常规、骨髓细胞形态学检查与T淋巴细胞亚群检测。结果:对照组总有效率为53.33%,观察组总有效率为70%,两组总有效率比较经卡方检验,观察组优于对照组(P<0.05)。两组治疗后血红蛋白水平均较治疗前提高(P<0.05),观察组白细胞计数与对照组比较有明显差异(P<0.05)。两组T淋巴细胞亚群比较:治疗后对照组和观察组的CD3^+和CD8^+比例与治疗前有明显差异(P<0.05),观察组CD4^+和CD4^+/CD8^+与治疗前和对照组治疗后均有显著性差异(P<0.05)。结论:参萸补血方对脾肾阳虚型CAA患者有良好疗效,其疗效机制与改善T细胞免疫功能有关。

Objective:To study the clinical efficacy and related immunological mechanism of Shenyu Buxue formula for patients suffering from chronic aplastic anemia(CAA)of spleen and kidney yang deficiency.Methods:120 patients suffering from CAA of spleen and kidney yang deficiency pattern were selected and randomly divided into treatment group and control group with 60 cases for each group.Both groups were given conventional anti-infection,hemostasis,blood transfusions and other symptomatic and supportive treatment.On the basis of conventional treatment,the control group was given prednisone(0.5 mg·kg-1·d-1).The treatment group was given Shenyu Buxue formula twice a day with one dose daily.It took one month as a course of treatment with 3 courses together for both groups.Blood routine,bone marrow cell morphology examination were conducted and T lymphocyte subsets were detected.Results:The total effective rate of the control group was 53.33%,while that of the treatment group was 70%.The total effective rate of the treatment group was better than that of the control group after chi square test(P<0.05).The hemoglobin levels in both groups after treatment were significantly higher than those before treatment(P<0.05).The white blood cell count of the treatment group was significantly different from that of the control group(P<0.05).Two groups of Twere significantly different from those before treatment(P<0.05).The levels of CD4+and CD4+/CD8+in the treatment group after treatment were significantly different from those before treatment and those in the control group after treatment(P<0.05).Conclusion:Shenyu Buxue formula has a favorable efficacy on patients suffering from CAA of spleen and kidney yang deficiency pattern.The therapeutic mechanism of the formula is related to the improvement of T cell immune function.