基于Th_(1)/Th_(2)失衡探讨再生障碍性贫血中西医治疗研究进展

Discussion on treatment progress of traditional Chinese and western medicine of aplastic anemia based on Th_(1)/Th_(2)

再生障碍性贫血(AA)是一种以T细胞免疫功能异常为主的骨髓造血衰竭性疾病,现代中医学将其归属于“髓劳”范畴。目前认为免疫调节机制的紊乱尤其是Th_(1)/Th_(2)失衡在AA发病中起着关键作用。近年来,发现一些新靶点对于调节Th_(1)和Th_(2)平衡具有显著作用,这些靶点作用包括抑制Th_(1)细胞的增殖、调节Th_(1)和Th_(2)细胞的分化及相关基因的表达、调控细胞信号传导等方面。研究证实,传统中医药通过多靶点、多途径的方式调控Th_(1)和Th_(2)失衡同样行之有效。补肾益髓法、健脾补肾法、益气养血法治疗AA以及中药人参、三七、马齿苋的有效成分,在调节免疫、促进造血及减轻药物不良反应方面发挥了重要作用。因此,探索针对Th_(1)和Th_(2)失衡可能存在的新靶点,总结中医中药对Th_(1)/Th_(2)干预的研究进展,这为中西医结合治疗AA提供了巨大潜力。

Aplastic anemia(AA)is a debilitating disease of bone marrow hematopoiesis mainly caused by abnormal T cell immune function.In modern Chinese medicine,it is classified as a“Suilao”.At present,it is believed that the disorder of immune regulation mechanism,especially the imbalance of Th_(1)/Th_(2),plays a key role in the pathogenesis of AA.In recent years,some new targets have been found to have significant effects on the regulation of Th_(1) and Th_(2) balance,including inhibition of Th_(1) cell proliferation,regulation of Th_(1) and Th_(2) cell differentiation and expression of related genes,and regulation of cell signal transduction.Studies confirm that traditional Chinese medicine regulation of Th_(1) and Th_(2) imbalance is also effective through multiple target and pathways,Bushen formula,tonifying spleen and kidney,nourishing Qi and blood and the active components of traditional Chinese medicine ginseng,notoginseng,purslane plays an important role in regulating immunity,promoting hematopoiesis and reducing the side effects of drugs.Therefore,exploring possible new targets for Th_(1) and Th_(2) imbalance and summarizing the research progress of TCM intervention on Th_(1)/Th_(2) provide great potential for the treatment of AA with integrated Chinese and western medicine.