【作者】 王树庆；

【导师】 唐由君；

【作者基本信息】 山东中医药大学 ， 中西医结合内科学， 2003， 硕士

【摘要】 目的：探讨愈障再生汤治疗慢性再生障碍性贫血（CAA）的临床疗效及作用机理。方法：将79例CAA患者随机分为治疗组和对照组。治疗组40例用愈障再生汤加西药常规治疗，对照组39例用西药常规治疗。观察临床疗效并分别于治疗前后采用单克隆抗体—免疫磁珠分离系统（MACS）分离、纯化骨髓CD₃₄⁺细胞；用DNA末端原位标记（TUNEL）技术分析骨髓CD₃₄⁺细胞原位凋亡状况；用SABC亲和细胞法和CMIAS系列多功能真彩图像分析仪检测骨髓CD₃₄⁺细胞bcl-2表达。结果：治疗组和对照组的基本治愈率、缓解率和总有效率分别为37.50％，25.00％，87.50％和20.51％，17.95％，61.54％。治疗组疗效明显优于对照组（P＜0.05）。骨髓CD₃₄⁺细胞的凋亡率，治疗前两组均较健康组明显增高（P＜0.01）；治疗后治疗组较治疗前明显减低（P＜0.01），与对照组比较差异有显著性（P＜0.01）。骨髓CD₃₄⁺细胞bcl-2表达的阳性率和OD值，治疗前两组均较健康组减低（P＜0.01）；治疗后治疗组明显升高，与对照组比较差异有显著性（P＜0.01和P＜0.05）。结论：以愈障再生汤为主中西医结合治疗CAA疗效可靠，安全无毒。其作用机制可能是通过上调凋亡抑制基因bcl-2表达，阻抑了骨髓CD₃₄⁺细胞的过度凋亡，使骨髓造血功能恢复重建。更多还原

【Abstract】 Objective : To investigate the clinical effect of Yuzhang zaisheng decotion（YZZSD） in treating chronic aplastic anemia （CAA） and to explore its mechanism. Methods: 79 CAA patients were randomly devided into two groups, 40 cases in the therapeutic group were treated with YZZSD and common western medicine, 39 cases in the control group were treated with usual western medicine. The clinical effects were observed, bone marrow CD34⁺ cells of patients were separated and purificated with monoclone antibody immunomagnetic beads（MACS）before and after treatment respectively, Apoptosls of CD34+ cells was analysised with （TUNEL） technique, bcl-2 expression in CD34⁺ cells was assayed with SABC technique and CMIAS multi function color photo instrument. Results: The cure rate, remission rate and total effective rate were 37.50%, 25.00% and 87.50% in treated group and 20.51%, 17.95%, 61.54% in control group. The curative effects of treated group were obviously better than those of control group （P<0. 05）. The apoptosis rates of both groups were significantly higher than that of healthpeople before treatment （P<0. 01）, After treatment the apoptosis rate of treated group was lower than before （P<0.01）, there was significantly difference between the treated group and control group （P<0. 01）. bcl-2 expression and OD number in bone marrow CD34+ cells of threated group were both obviously higher than that of control group（P<0.01 and P<0.05）. respectively. Conclusion: Yuzhang zaisheng Decotion combined with western medicine to treat CAA patients was safety and its clinical effect was good. Our study suggested that YZZSD might increase bcl-2 expression in CD34+ cells and inhibit apoptosis of bone marrow CD34+ cells to reconstruct the hematopoiesis function of bone marrow.更多还原