【作者】 杨薇；

【导师】 孙伟正；

【作者基本信息】 黑龙江中医药大学 ， 中医内科学， 2006， 博士

【摘要】 目的:探讨补髓生血颗粒剂对慢性再生障碍性贫血(以下简称为CAA)患者的临床疗效及治疗前后骨髓造血干/祖细胞相关粘附分子L-选择素/CD62L、酪氨酸激酶受体FLT-3/CD135的表达水平和血清FL、IL-13水平。 方法:本研究将入选的68例CAA病人经半随机开放分为实验组和对照组,其中实验组35例,对照组33例。实验组给予补髓生血颗粒剂,对照组给予再障生血片,疗程为3个月,2个疗程后观察疗效,并对CAA患者治疗前后血象、骨髓象与CD62L、FLT-3、FL及IL-13的表达水平进行对比分析。 采用流式细胞技术检测CAA患者治疗前后骨髓CD62L及FLT-3的表达水平;采用酶联免疫(ELISA)法检测CAA患者治疗前后血清FL、IL-13水平的变化。 结果: 1.补髓生血颗粒剂治疗CAA的临床疗效优于再障生血片对照组(P<0.05),阳虚型疗效优于阴虚型(P<0.05)。 2.酪氨酸激酶受体FLT-3、CD62L在CAA发病中呈低表达状态,补髓生血颗粒能纠正CD62L的低表达,但对FLT-3的纠正作用不理想。 3. Flt-3配体FL、IL-13在CAA发病中呈高表达状态,补髓生血颗粒能有效降低二者的表达水平,且明显优于对照组再障生血片。 结论:补髓生血颗粒治疗CAA疗效优于再障生血片,进一步证实了本病有“阳虚易治,阴虚难调”的治疗规律。补髓生血颗粒可能通过提高酪氨酸激酶受体FLT-3、CD62L的表达水平来修复造血干/祖细胞的损伤,改善骨髓基质细胞的粘附功能,促进造血细胞的增殖、分化;同时补髓生血颗粒还可能通过降低FL、IL-13表达水平,调节T淋巴细胞分泌紊乱,抑制异常免疫功能介导的细胞毒性作用,减轻骨髓造血功能的损伤。补髓生血颗粒是防治更多还原

【Abstract】 Objective: Discussed the clinical effect of chronic aplastic anemia (CAA) with Busuishengxue granule ,and observed the difference in expression levels of CD62L 、 FL、 FLT3、 IL-13 in CAA patients before and after treatment.Method: 68 CAA patients were randomly divided into experiment group and control group in which 35 patients in the experiment group while 33 in another. One curse of treatment was three months.We observed the clinical effect after two curses. Before and after treatment we observed and analyzed the change of hemogram、myelogram and the expression levels of CD62L、FLT3、 FL and IL-13.The experiment applied flow cytometer method (FCM) to examine the expression levels of bone marrow CD62L 、 FLT3, ELISA method to examine the change of FL and IL-13.RESULT: 1.The effect of Busuishengxue granule was superior to that of Zaizhangshengxue tablet (p<0.05). In experimental group, the curative effect of Yang deficiency type was superior to that of Yin deficiency type (P<0.05). 2. The expression levels of FLT3、 CD62L in CAA patients were low. Busuishengxue granule could improve the low expression level of CD62L ,but the effect to FLT3 was not satisfied.3. The expression levels of FL、 IL-13 in CAA patients were high. Busuishengxue granule could effectively reduce their expression levels and was superior to Zaizhangshengxue tablet evidently.Conclusion: The effect of Busuishengxue granule to CAA was superior to that of Zaizhangshengxue tablet. Our experiments further testified the theory "Yin deficiency is easy to treat, but Yang deficiency is difficult to treat". Busuishengxue granule could raise the expression levels of FLT3 、 CD62L to restore the damage ofhematopoietic stem cell,improve the adhesion function of BMSC, promote the multiplication and differentiation of hematopoietic cell. Busuishengxue granule could reduce the expression levels of FL% IL-13 to regulate T lymphocyte secretion disorder,restrain toxic cell effect led by abnormal immune function,relieve the damage of bone marrow hematopoietic function.Busuishengxue granule is an effective drug to treat CAA, and is worthy of further study and development.更多还原