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
目的评价益气养阴活血法联合生活方式干预治疗2型糖尿病前期的疗效和安全性。方法检索中国生物医学文献数据库(CBMDisc)、《中国医学学术会议论文数据库》(CMAC)、中国期刊全文数据库(CNKI)、中文科技期刊全文数据库(VIP)、万方数据库、...目的评价益气养阴活血法联合生活方式干预治疗2型糖尿病前期的疗效和安全性。方法检索中国生物医学文献数据库(CBMDisc)、《中国医学学术会议论文数据库》(CMAC)、中国期刊全文数据库(CNKI)、中文科技期刊全文数据库(VIP)、万方数据库、Pub Med、EMbase、Web of Science,检索时限截至2013年12月。纳入益气养阴活血法联合生活方式干预治疗2型糖尿病前期的随机对照试验(RCT)。由2位研究人员根据纳入与排除标准独立进行文献筛选、数据提取、质量评价并交叉核对结果,采用Rev Man 5.1软件进行Meta分析。结果共纳入17个RCT,共1497例2型糖尿病前期患者。Meta分析显示:益气养阴活血法为主的中药复方加用生活方式干预与对照组比较,糖尿病的发生率降低,糖调节受损恢复正常率较高,对空腹血糖、餐后2 h血糖的影响其差异有统计学意义,对糖化血红蛋白的影响其差异没有统计学意义。但因纳入文章研究设计质量不高,故不能有力证明益气养阴活血法组优于对照组,只能说明对于糖尿病前期的治疗益气养阴活血法可能优于对照组。有3个研究报道了不良事件,未见严重不良事件的报道。结论基于当前临床证据,糖尿病前期的治疗益气养阴活血法可能优于对照组,但尚需设计严格的临床研究进一步验证。展开更多
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.
文摘目的评价益气养阴活血法联合生活方式干预治疗2型糖尿病前期的疗效和安全性。方法检索中国生物医学文献数据库(CBMDisc)、《中国医学学术会议论文数据库》(CMAC)、中国期刊全文数据库(CNKI)、中文科技期刊全文数据库(VIP)、万方数据库、Pub Med、EMbase、Web of Science,检索时限截至2013年12月。纳入益气养阴活血法联合生活方式干预治疗2型糖尿病前期的随机对照试验(RCT)。由2位研究人员根据纳入与排除标准独立进行文献筛选、数据提取、质量评价并交叉核对结果,采用Rev Man 5.1软件进行Meta分析。结果共纳入17个RCT,共1497例2型糖尿病前期患者。Meta分析显示:益气养阴活血法为主的中药复方加用生活方式干预与对照组比较,糖尿病的发生率降低,糖调节受损恢复正常率较高,对空腹血糖、餐后2 h血糖的影响其差异有统计学意义,对糖化血红蛋白的影响其差异没有统计学意义。但因纳入文章研究设计质量不高,故不能有力证明益气养阴活血法组优于对照组,只能说明对于糖尿病前期的治疗益气养阴活血法可能优于对照组。有3个研究报道了不良事件,未见严重不良事件的报道。结论基于当前临床证据,糖尿病前期的治疗益气养阴活血法可能优于对照组,但尚需设计严格的临床研究进一步验证。
