目的探讨补肾活血法对慢性再生障碍性贫血小鼠的干预作用及其机制。方法建立肾虚合并慢性再生障碍性贫血小鼠模型,将30只小鼠分成中药组、模型组和对照组,每组10只。中药组小鼠给予中药汤剂灌胃0.2 m L/次,2次/d,共60 d,模型组和对照组...目的探讨补肾活血法对慢性再生障碍性贫血小鼠的干预作用及其机制。方法建立肾虚合并慢性再生障碍性贫血小鼠模型,将30只小鼠分成中药组、模型组和对照组,每组10只。中药组小鼠给予中药汤剂灌胃0.2 m L/次,2次/d,共60 d,模型组和对照组小鼠给予灌胃相同剂量等渗Na Cl溶液。观察小鼠一般情况;于苯试剂皮下注射第16、25次后检测所有小鼠的白细胞、血红蛋白及血小板水平;采用酶联免疫吸附试验检测血管内皮生成因子(VEGF)和基质细胞衍生因子1a(SDF-1a);同时,电子显微镜下计算骨髓有核细胞个数;苏木素-伊红(HE)染色观察骨髓病理情况。结果模型组和中药组的小鼠逐渐出现体质量下降、乏力萎靡、毛发枯疏、四肢苍白等表现。随着中药治疗时间延长,中药组小鼠的上述症状均有不同程度恢复。三组小鼠间白细胞、血红蛋白及血小板计数的比较,差异均有统计学意义(F=16.536、9.273、5.667,P均<0.05),与对照组相比,模型组及中药组小鼠相同时间点上述指标均明显下降(P均<0.05),且当苯试剂皮下注射第25次后,中药组小鼠的白细胞、血红蛋白及血小板较模型组均明显升高(P均<0.05)。三组小鼠间VEGF、SDF-1a水平及骨髓有核细胞的比较,差异均有统计学意义(F=11.231、7.924、8.455,P均<0.05),且与对照组比较,模型组及中药组小鼠的VEGF[(342±11)、(235±13)、(278±13)ng/L]、SDF-1a[(110±13)、(85±11)、(93±12)ng/L]水平及骨髓有核细胞[(94±15)、(72±11)、(83±13)个/HP]均明显下降,且模型组较中药组更低(P均<0.05)。HE染色显示中药组及模型组小鼠的粒、红系及巨核细胞均有不同程度减少,但模型组上述情况更严重。结论补肾活血祛瘀法能够改善慢性再生障碍性贫血小鼠的临床症状,对其造血恢复有一定的作用,可能通过恢复其VEGF和SDF-1a水平有关。展开更多
OBJECTIVE:To compare the efficacy of modified treatments based on "kidney reinforcing" in the management of chronic aplastic anemia(CAA),and explore their advantages and specialties.METHODS:One hundred and e...OBJECTIVE:To compare the efficacy of modified treatments based on "kidney reinforcing" in the management of chronic aplastic anemia(CAA),and explore their advantages and specialties.METHODS:One hundred and eleven patients with CAA were randomly divided into three groups:kidney reinforcing alone(KA),"kidney reinforcing and Qi tonifying"(KQ),and "kidney reinforcing and blood circulation invigorating"(KC).Normal and positive control groups were also formed.All patients were treated for 6 months(two courses).Hemograms,Traditional Chinese Medicine(TCM) syndrome scores,and therapeutic effects were assessed,and changes in T-lymphocyte subsets,regulatory T cells and cytokines were detected.RESULTS:The KQ and KC groups had lower TCM syndrome scores than the positive control group after 6 months(P < 0.05).The KQ group had a higher overall efficacy than the positive control group after 3 months(P < 0.05),while platelet counts increased in the KC group after 6 months(P < 0.05).CD3+ T-lymphocyte ratios decreased only in the KQ group,while CD3 + CD4 + CD8-Tlymphocytes increased only in the KC group after 6 months(P <0.05).Levels of interferon-γ,tumor necrosis fac-tor-α,interleukin(IL)-2 and IL-6 decreased and levels of IL-4 and IL-10 increased in all treated groups after 6 months.Levels of IL-6 in the KQ and KC groups were lower than those in the positive control group(P < 0.05).CONCLUSION:Treatments based on kidney reinforcing have a rebalancing effect on cytotoxic and T helper cells,and regulate expression of interferon-γ,IL-2,IL-6 and IL-4.KQ may be more effective in treating CAA,and KC may have an advantage in platelet recovery.展开更多
文摘目的探讨补肾活血法对慢性再生障碍性贫血小鼠的干预作用及其机制。方法建立肾虚合并慢性再生障碍性贫血小鼠模型,将30只小鼠分成中药组、模型组和对照组,每组10只。中药组小鼠给予中药汤剂灌胃0.2 m L/次,2次/d,共60 d,模型组和对照组小鼠给予灌胃相同剂量等渗Na Cl溶液。观察小鼠一般情况;于苯试剂皮下注射第16、25次后检测所有小鼠的白细胞、血红蛋白及血小板水平;采用酶联免疫吸附试验检测血管内皮生成因子(VEGF)和基质细胞衍生因子1a(SDF-1a);同时,电子显微镜下计算骨髓有核细胞个数;苏木素-伊红(HE)染色观察骨髓病理情况。结果模型组和中药组的小鼠逐渐出现体质量下降、乏力萎靡、毛发枯疏、四肢苍白等表现。随着中药治疗时间延长,中药组小鼠的上述症状均有不同程度恢复。三组小鼠间白细胞、血红蛋白及血小板计数的比较,差异均有统计学意义(F=16.536、9.273、5.667,P均<0.05),与对照组相比,模型组及中药组小鼠相同时间点上述指标均明显下降(P均<0.05),且当苯试剂皮下注射第25次后,中药组小鼠的白细胞、血红蛋白及血小板较模型组均明显升高(P均<0.05)。三组小鼠间VEGF、SDF-1a水平及骨髓有核细胞的比较,差异均有统计学意义(F=11.231、7.924、8.455,P均<0.05),且与对照组比较,模型组及中药组小鼠的VEGF[(342±11)、(235±13)、(278±13)ng/L]、SDF-1a[(110±13)、(85±11)、(93±12)ng/L]水平及骨髓有核细胞[(94±15)、(72±11)、(83±13)个/HP]均明显下降,且模型组较中药组更低(P均<0.05)。HE染色显示中药组及模型组小鼠的粒、红系及巨核细胞均有不同程度减少,但模型组上述情况更严重。结论补肾活血祛瘀法能够改善慢性再生障碍性贫血小鼠的临床症状,对其造血恢复有一定的作用,可能通过恢复其VEGF和SDF-1a水平有关。
基金Supported by Special Item of Important Disease of Zhejiang Province Traditional Chinese Medicine Sic-Tech Innovation Platform(Effect and Mechanism of Traditional Chinese Medicine on the Treatment of Aplastic Anemia and the Funding of Traditional Chinese Medicine Assessment Criterion,No.2009ZDJB01)Subject of Key Sic-Tech Innovation Team of Zhejiang Province(Clinical Study on Treatment of Chronic Aplastic Anemia by Tonifying Kidney and Promoting Blood Circulation,No.2011R09042-02)+2 种基金Special Research Funds for Traditional Chinese Medicine Industry(Effect of Traditional Chinese Medicine on the Treatment of Risk Factors of Chronic Aplastic Anemia,No.201107001)Special Research Funds for Traditional Chinese Medicine Industry(Clinical Study on the Diagnosis and Treatment of Aplastic Anemia Based on the Syndrome And Stage Differentiation,No.201407001)Zhejiang Provincial Traditional Chinese Medicine Administration Bureau Program(Establishment of Traditional Chinese Medicine Clinical Pathway on Aplastic Anemia,No.2010ZA039)
文摘OBJECTIVE:To compare the efficacy of modified treatments based on "kidney reinforcing" in the management of chronic aplastic anemia(CAA),and explore their advantages and specialties.METHODS:One hundred and eleven patients with CAA were randomly divided into three groups:kidney reinforcing alone(KA),"kidney reinforcing and Qi tonifying"(KQ),and "kidney reinforcing and blood circulation invigorating"(KC).Normal and positive control groups were also formed.All patients were treated for 6 months(two courses).Hemograms,Traditional Chinese Medicine(TCM) syndrome scores,and therapeutic effects were assessed,and changes in T-lymphocyte subsets,regulatory T cells and cytokines were detected.RESULTS:The KQ and KC groups had lower TCM syndrome scores than the positive control group after 6 months(P < 0.05).The KQ group had a higher overall efficacy than the positive control group after 3 months(P < 0.05),while platelet counts increased in the KC group after 6 months(P < 0.05).CD3+ T-lymphocyte ratios decreased only in the KQ group,while CD3 + CD4 + CD8-Tlymphocytes increased only in the KC group after 6 months(P <0.05).Levels of interferon-γ,tumor necrosis fac-tor-α,interleukin(IL)-2 and IL-6 decreased and levels of IL-4 and IL-10 increased in all treated groups after 6 months.Levels of IL-6 in the KQ and KC groups were lower than those in the positive control group(P < 0.05).CONCLUSION:Treatments based on kidney reinforcing have a rebalancing effect on cytotoxic and T helper cells,and regulate expression of interferon-γ,IL-2,IL-6 and IL-4.KQ may be more effective in treating CAA,and KC may have an advantage in platelet recovery.
