慢性再生障碍性贫血的中医辨证与骨髓各项指标关系的研究

Investigation on Inner Link of Dialectical Type of Chinese Medicine of Chronic Aplastic Anemia and Each Marker of Bone Marrow

目的:探讨慢性再生障碍性贫血的中医辨证分型与骨髓各项指标之间的内在联系。方法:对60例慢性再生障碍性贫血患者进行骨髓的分类、小巨核酶标、小组化、骨髓活检检测。结果:慢性再生障碍性贫血患者因中医辨证分型不同,骨髓异常程度也不同,由重至轻依次为肾阴虚型、肾阴阳两虚型、肾阳虚型。肾阴虚型骨髓增生程度重度减低,无巨核细胞,骨髓活检以造血细胞缺乏为特点。肾阴阳两虚型骨髓增生程度明显减低,中性粒细胞碱性磷酸酶阳性指数增高,骨髓活检以造血细胞减少为特点。肾阳虚型骨髓增生程度活跃减低,中性粒细胞碱性磷酸酶阳性指数明显增高,骨髓活检以造血细胞成熟障碍为特点。同时,骨髓活检还可见基质水肿、毛细血管减少。结论:慢性再生障碍性贫血存在着造血微环障碍,因分型不同骨髓的变化也不同。

Objective: To investigate inner link of dialectical type of Chinese medicine of chronic aplastic anemia and each marker of bone marrow. Methods: The marrow from 60 sufferers of chronic aplastic anemia were classified, marked on micro-huge nuclear with enzyme, divided into groups, and also been examined in live. Result: Abnormality of marrow were different according to their dialectical type of Chinese medicine. They were 4 types, deficiency of Yin type of kidney, both deficiencies in negative and positive types, deficiency of yang type of kidney according to their degree of abnormity. The deficiency of Yin type of kidney, hyperplasia of marrow diminished seriously, without megakaryocyte, be characterized by lack of hematoblast in live examination. Both deficiency in negative and positive types, hyperplasia of marrow were dominate seriously, masculine index of neutrophil alkaline phosphatase were heighten, characterized by reduction of hematoblast in live examination. Deficiencies of yang type of kidney, hyperplasia of marrow were decreased, index of neutrophil alkaline phosphatase were heighten in evidencely, characterized by holding back of maturity of hematoblast in live examination. On the same time, edema of base, capillary reduction could be seen in live examination. Conclusion: Hematopoietic microenviroment were in chronic aplastic anemia, the changes of marrow were diffirent because of different type of chronic aplastic anemia.