【作者】 李巍；

【导师】 孙伟正；

【作者基本信息】 黑龙江中医药大学 ， 中医内科学， 2001， 博士

【摘要】 本文以导师三十多年的临床经验所总结出来的补髓生血冲剂为治疗方剂，对36例慢性再障患者治疗前后的外周血象、骨髓象以及疗效三项指标进行观察并与对照组进行对比，结果疗后治疗组的外周血象、骨髓象改变情况以及疗效均与对照组有显著性差异（P＜0.05），提示补髓生血冲剂治疗CAA的疗效优于再障生血片。实验研究方面，本项研究采用双标免疫组化法和ELISA法，对正常组以及治疗组、对照组治疗前后骨髓进行检测，结果显示该冲剂能提高CD₃₄⁺、CD₃₄⁺bcl-2表达水平，降低CD₃₄⁺c-myc、IFN-γ、TNF-α表达水平，揭示补髓生血冲剂是通过改变造血干细胞凋亡相关基因的表达，降低了造血负调控因子的释放，抑制其细胞凋亡和促进造血干细胞数量的增加，达到治疗目的。在临床观察中发现肾阳虚型病情较轻，治疗较易；肾阴虚型病情较重，治疗较难。在研究中还发现了肾阳虚型疗前疗后CD₃₄⁺、CD₃₄⁺bcl-2表达水平均局于肾阴虚型，CD₃₄⁺c-myc、IFN-γ、TNF-α表达水平均低于肾阴虚型。这可能是“阳虚易治，阴虚难调” 的机理所在。更多还原

【Abstract】 In this article, the treatment group including 36 cases of chronic aplastic anemia(CAA) patients were treated by the soluble granules of Bu Sui Sheng Xue (BSSX) which comes from professer Suen wei zheng’s clinical experience more than 30 years.Qbserved ? the changes of hemogram mylogram and curative effect,compared with 20 cases of the control group .The result showed that the difference after treatment was significant (P<0.05) between two groups.It prompts that the soluble granules of BSSX’s currative effect for CAA is better than the tablet of Zai Zhang Sheng Xue.In the experiment studty,detecting bone marrow was applied double- label immunohistochemical and ELISA method before and after treatment in two groups,and compared with the normal group.The result showed that the soluble granules of BSSX could raised CD34~N CD34~bcl-2 expression level ,decrease CD34c-myc-. IFN- Y TNF-. a expression level. It indicated that the soluble granules of BSSX is effective for CAA by repressing apoptosis of hemopoietic stem cell,varying relative gene of apoptosis of hemopoietic stem cell and increasing the quantity of hemopoietic stem cell.In the studty, we observed that Kindey Yang Deficiency was better to patient’s condition and easier to treat than Kindey Yin Deficiency.The CD34~+. CD34~bc1-2 expression level of Kindey Yang Deficiency type was higher than that of Kindey Yin Deficiency type, CD34~c-myc IFN- +. TNF- a expression level was lower than Kindey Yin Deficiency type before and after treament.It may be the main mechanism of he treatment to Yin Deficiency is more difficult than Yang Deficiency更多还原