复方参鹿颗粒治疗较低危MDS的临床疗效及其对骨髓p38MAPK通路相关蛋白的影响

Clinical efficacy of Compound Shenlu Granule in the treatment of relative low-risk myelodysplastic syndromes and its effects on bone marrow p38MAPK pathway related proteins

目的探讨复方参鹿颗粒治疗较低危骨髓增生异常综合征(MDS)的临床疗效及其对骨髓p38MAPK通路相关蛋白表达的影响。方法选取60例较低危MDS患者,随机分为复方参鹿颗粒组(简称"FSG组")和安特尔组,每组各30例。两组患者均给予西医常规支持治疗,在此基础上,FSG组患者给予复方参鹿颗粒口服,安特尔组患者给予安特尔口服,两组疗程均为3个月。评价并比较两组的临床疗效,检测两组患者的血常规,采用实时定量PCR法检测两组患者的p38MAPK通路相关蛋白p38、p53、bcl-xl、bcl-2、bax mRNA表达。结果经治疗后,FSG组血液学改善17例(62.96%)、治疗失败10例(37.04%),安特尔组血液学改善15例(53.57%)、治疗失败13例(46.43%),两组临床疗效比较差异无统计学意义(P>0.05)。治疗后,FSG组患者的RBC、WBC、Hb、PLT水平较治疗前均显著上升(P<0.05,P<0.01),安特尔组患者的RBC水平亦明显上升(P<0.05),且FSG组患者的Hb水平明显高于安特尔组(P<0.05)。治疗后,FSG组患者的p38、p53、bax表达下降(P<0.05),安特尔组患者的p38表达亦下降(P<0.05),且FSG组患者的p38、p53表达明显低于安特尔组(P<0.05)。结论复方参鹿颗粒能有效改善较低危MDS患者骨髓的无效造血,其机制可能与抑制p38MAPK通路有关。

Objective To discuss the clinical efficacy of Compound Shenlu Granule in the treatment of relative low-risk myelodysplastic syndromes( MDS) and its effects on bone marrow p38MAPK pathway related proteins. Methods 60 relative low-risk MDS patients were randomly divided into the Compound Shenlu Granule group and Andriol group,30 cases in each group. Both groups were treated with conventional therapy of western medicine. Based on this,the Compound Shenlu Granule group was treated with Compound Shenlu Granule and the Andriol group was treated with Andriol( testosterone undecanoate soft capsules)respectively,with a course of 3 months. The clinical efficacy was evaluated and compared,and the blood routine indicators were examined. The mRNA expressions of p38,p53,Bcl-xl,Bcl-2 and Bax were detected by real time quantitative PCR. Results The improvement on hematology was observed in 17 cases of Compound Shenlu Granule group( accounted for 62.96%) and treatment failure was observed in 10 cases( accounted for 37.04%). The improvement on hematology was observed in 15 cases of Andriol group( accounted for 53.57%) and treatment failure was observed in 13 cases( accounted for 46.43%). There was no statistically significant difference on the clinical efficacy between the two groups( P > 0.05). After treatment,the levels of RBC,WBC,Hb and PLT in the Compound Shenlu Granule group were significantly increased( P<0.05,P<0.01),the RBC level was also obviously increased in the Andriol group( P<0.05),and the Hb level in the Compound Shenlu Granule group was higher than that in the Andriol group( P<0.05). After treatment,the expressions of p38,p53 and Bax were decreased in the Compound Shenlu Granule group( P < 0.05),the p38 expression was also decreased in the Andriol group( P < 0.05),the expressions of p53 and p38 in the Compound Shenlu Granule group were lower than those in the Andriol group( P < 0.05). Conclusion Compound Shenlu Granule can effectively improve the ineffective hematopoiesis in relative low-risk MDS patients. The mechanism may be related to the inhibition on p38MAPK pathway.