补肾中药为主的中西医结合方法治疗再生障碍性贫血的实践与展望

Practice and prospect of treating aplastic anemia with integration of traditional Chinese and western medicine mainly with Chinese herbal medicines for tonifying kidney

再生障碍性贫血(aplastic anemia,AA)是一组以造血干细胞损伤、骨髓脂肪化、外周血全血细胞减少为特征的骨髓造血功能衰竭性疾病。中国中医科学院西苑医院血液科一直致力于AA的临床和基础研究,提出AA的病程大致可分为以异常免疫为主和以骨髓衰竭为主两个阶段,发现非重型再生障碍性贫血(non-severe aplastic anemia,NSAA)患者主要以肾阳虚型为主,重型AA(SAA)患者以肾阴虚型为主,血小板和网织红细胞能反映AA患者的临床疗效和累积生存率;临床采用以补肾中药为主的中西医结合方法治疗AA疗效显著,能有效改善患者免疫系统紊乱状态,为AA的中西医治疗推广提供依据。

Aplastic anemia(AA)is a group of bone marrow hematopoietic failure characterized by hematopoietic stem cell in-jury,bone marrow adipose disease and peripheral blood pancytopenia disease.The Hematology Department of Xiyuan Hospital,China Academy of Chinese Medical Sciences has been devoted to the clinical and basic research of AA and first proposed that the oc-currence and development of AA can be roughly divided into two stages,that is abnormal immunity and bone marrow failure.At the same time,it was found that the patients with kidney Yang deficiency type were mainly seen in NSAA patients,and kidney Yin defi-ciency type were mainly found in SAA patients.Platelets and reticulocytes can reflect the clinical efficacy and cumulative survival rate of AA patients;the clinical application of integrated traditional Chinese and western medicine based on Chinese herbal medicines for tonifying kidney has significant curative effect,which can effectively improve the immune system disorder of AA patients.On the ba-sis of previous studies,we participated in the compilation of TCM clinical practice guidelines for AA,providing a basis for the pro-motion of integrative TCM and western medicine treatment for AA.