摘要
[目的]观察免疫抑制治疗联合“补肾健脾活血”法治疗重型再生障碍性贫血(SAA)临床疗效及对T淋巴细胞亚群的影响,探讨其在促进SAA免疫抑制治疗(IST)后早期造血恢复中的作用机制。[方法]将60例SAA患者随机分为治疗组和对照组各30例。治疗组予免疫抑制联合中药治疗剂,对照组予免疫抑制联合中药模拟剂。疗程均为3个月,随访至1年。观察两组临床疗效及治疗前后T淋巴细胞亚群变化。[结果]治疗组总有效率高于对照组,但差异无统计学意义(P>0.05)。治疗后两组外周血细胞计数均较治疗前改善,差异有统计学意义(P<0.05或P<0.01)。治疗组治疗后血红蛋白计数高于对照组,差异有统计学意义(P<0.05)。与治疗前比较,CD3^+CD4^-CD8^+/CD3^+CD19^-细胞比例及CD4^+CD25^+Foxp3^+/CD4^+CD25^+细胞比例较治疗前降低,与治疗前相比差异有统计学意义(P<0.05),且CD4^+CD25^+Foxp3^+细胞比例降低与对照组比较,差异有统计学意义(P<0.05)。[结论]免疫抑制剂联合中医“补肾健脾活血”法治疗SAA疗效确切,其作用机制可能与减少CD8^+细胞数量,增加CD4^+细胞数量,提高Foxp3^+的表达有关。
[Objective]To observe the clinical efficacy of immunosuppressive therapy combined with Bushen Jianpi Huoxue methodfor severe aplastic anemia(SAA)and its effect on T-lymphocyte subsets,and to explore its mechanism in promoting early hematopoietic recovery after IST of severe aplastic anemia.[Methods]Sixty SAA patients with SAA randomly divided into treatment group(n=30)and control group(n=30).The treatment group was treated with IST combined with traditional Chinese medicine therapy,while the control group was treated with IST combined with traditional Chinese medicine simulator.The treatment lasted for 3 months and follow-up visits lasted for 1 year.The clinical efficacy andthe changes of T lymphocytes subsetsbefore and after treatment were observed.[Results]The total effective rate in the treatment group was higher than that in the control group,but there was no significant difference(P>0.05).Aftertreatment,the blood cell counts in the two groups were improved compared with those of before treatment(P<0.05,P<0.01).The hemoglobin of treatment group was significantly higher than that of control group(P<0.05).Compared with the data before treatment in treatment group,the ratio of CD3^+CD4^-CD8^+/CD3^+CD19^-cells and CD4^+CD25^+Foxp3^+/CD4^+CD25^+cells decreased(P<0.05),and the ratio of CD4^+CD25^+Foxp3^+cells was lower than that in the control group(P<0.05).[Conclusion]The combination of IST and Bushen Jianpi Huoxue method is effective in the treatment of SAA,and its mechanism may be related to the decrease of CD8^+cells,the increase of CD4^+cells and the expression of Foxp3^+.
作者
谈栩铖
赵琳
赵艺涵
邱仲川
瞿玮颖
朱小勤
张文君
陆泳
TAN Xucheng;ZHAO Lin;ZHAO Yihan;QIU Zhongchuan;QU Weiying;ZHU Xiaoqin;ZHANG Wenjun;LU Yong(Hematology Department,Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 200021,China;Hematology Department,Tongji Hospital of Tongji University,Shanghai 200092,China)
出处
《天津中医药》
CAS
2020年第4期402-406,共5页
Tianjin Journal of Traditional Chinese Medicine
基金
上海市进一步加快中医药事业发展三年行动计划(ZY3-JSFC-2-1036)
2014年中医药行业科研专项(201407001)。
关键词
重型再生障碍性贫血
中西医结合治疗
免疫抑制治疗
severe aplastic anemia
combined treatment of traditional Chinese medicine and Western medicine
immunosuppressive therapy