CAJ | 학술논문

目的评判复方参鹿颗粒对肾阳虚型骨髓增生异常综合征(MDS)(难治性贫血/难治性血细胞减少伴多系造血异常)(RA/RCMD)造血调控情况.方法 30例MDS-RA/RCMD患者随机分成复方参鹿颗粒组(简称参鹿组)(15例)和十一酸睾酮组(15例),测评治疗前后外周血象、T细胞亚群+自然杀伤(NK)细胞、骨髓细胞免疫表型.结果参鹿组与治疗前相比,红细胞、血色素、血小板有明显上升,治疗前分别为(2.39±0.99)×1012/L、(84.47±28.68)g/L、(81.13±96.85)×109/L,治疗后分别为(2.80±0.98)×1012/L、(94.87±25.63)g/L、(98.67±107.9)×109/L,差异均有统计学意义(t=4.0359、t=2.7009、t=2.2573,均P<0.05),十一酸睾酮组仅有血红蛋白数量上升,治疗前为(71.93±27.53)g/L,治疗后为(80.07±26.03)g/L,差异有统计学意义(t=2.3125,P=0.0365);参鹿组治疗后CD+4、CD+8、CD+4/CD+8、NK细胞均达到或接近正常值,分别为(37.9±5.9)%、(24.0±5.8)%、1.75±0.83、(13.0±6.9)%,与治疗前的(29.3±11.7)%、(29.6±5.8)%、1.12±0.59、(8.8±5.7)%相比差异有统计学意义(t=2.6194、t=2.6595、t=2.6581、t=2.2288,均P<0.05),十一酸睾酮组治疗后仅CD+8、CD+4/CD+8接近正常值,分别为(22.1±7.5)%、1.50±0.74,与治疗前(26.6±7.5)%、1.18±0.55相比差异有统计学意义(t=2.2377,P=0.0420;t=2.9352,P=0.0109),治疗后,参鹿组CD+4表达率为(37.9±5.9)%,十一酸睾酮组为(30.5±12.6)%,差异有统计学意义(t=2.1738,P=0.0474);参鹿组对骨髓细胞CD+13、CD+33、CD+34、CD+64、CD+117的异常阳性表达调控能力强于安雄组(前三者u=2.76、u=3.39、u=2.85,均P<0.01,后两者u=2.17、u=2.46,均P<0.05).结论复方参鹿颗粒能有效调控肾阳虚型MDS-RA/RCMD正常造血功能.
목적 평판복방삼록과립대신양허형골수증생이상종합정(MDS)(난치성빈혈/난치성혈세포감소반다계조혈이상)(RA/RCMD)조혈조공정황.방법 30례MDS-RA/RCMD환자수궤분성복방삼록과립조(간칭삼록조)(15례)화십일산고동조(15례),측평치료전후외주혈상、T세포아군+자연살상(NK)세포、골수세포면역표형.결과 삼록조여치료전상비,홍세포、혈색소、혈소판유명현상승,치료전분별위(2.39±0.99)×1012/L、(84.47±28.68)g/L、(81.13±96.85)×109/L,치료후분별위(2.80±0.98)×1012/L、(94.87±25.63)g/L、(98.67±107.9)×109/L,차이균유통계학의의(t=4.0359、t=2.7009、t=2.2573,균P<0.05),십일산고동조부유혈홍단백수량상승,치료전위(71.93±27.53)g/L,치료후위(80.07±26.03)g/L,차이유통계학의의(t=2.3125,P=0.0365);삼록조치료후CD+4、CD+8、CD+4/CD+8、NK세포균체도혹접근정상치,분별위(37.9±5.9)%、(24.0±5.8)%、1.75±0.83、(13.0±6.9)%,여치료전적(29.3±11.7)%、(29.6±5.8)%、1.12±0.59、(8.8±5.7)%상비차이유통계학의의(t=2.6194、t=2.6595、t=2.6581、t=2.2288,균P<0.05),십일산고동조치료후부CD+8、CD+4/CD+8접근정상치,분별위(22.1±7.5)%、1.50±0.74,여치료전(26.6±7.5)%、1.18±0.55상비차이유통계학의의(t=2.2377,P=0.0420;t=2.9352,P=0.0109),치료후,삼록조CD+4표체솔위(37.9±5.9)%,십일산고동조위(30.5±12.6)%,차이유통계학의의(t=2.1738,P=0.0474);삼록조대골수세포CD+13、CD+33、CD+34、CD+64、CD+117적이상양성표체조공능력강우안웅조(전삼자u=2.76、u=3.39、u=2.85,균P<0.01,후량자u=2.17、u=2.46,균P<0.05).결론 복방삼록과립능유효조공신양허형MDS-RA/RCMD정상조혈공능.
Objective To evaluate haematogenesis of complex Shenlu granule in treating myelodysplastic syndrome (RA/RCMD) due to kidney yang deficiency. Methods The qualified cases were randomly divided into the complex Shenlu granule group and the Andriol group. During treatment, indexes such as peripheral hemogram, T cell subgroup, NK cell and immunological phenotypic expression of BMC were tested. Results Compared with prior treatment, Rbc, Hb and Plt have significantly increased in Shenlu group [prior treatment: (2.39±0.99)×1012/L, (84.47±28.68) g/L, (81.13±96.85) ×109/L; post-treatment (2.80±0.98)×1012/L, (94.87±25.63) g/L, (98.67±107.9)×109/L, and the difference was statistically significant (t =4.0359, P =0.001, t =2.7009, P =0.0172, t =2.2573, P = 0.0405). Andriol group has only increased Hb [prior treatment: (71.93±27.53) g/L; post-treatment (80.07±26.03) g/L] was statistically significant (t =2.3125,P =0.0365). After treatment, CD+4, CD+8, CD+4/CD+8, and NK were at or near normal value in Shenlu group (37.9±5.9) %, (24.0±5.8) %, 1.75±0.83, (13.0±6.9) %, compared with prior treatment (29.3±11.7) %, (29.6±5.8) %,1.12±0.59, (8.8±5.7) %. The difference was statistically significant (t =2.6194, P =0.0202, t = 2.6595, P =0.0187,t =2.6581, P =0.0187, t =2.2288, P =0.0427, P <0.05), and CD+8, CD+4/CD+8 close to normal in Andriol group [(22.1 ±7.5) %, 1.50±0.74], prior treatment [(26.6±7.5) %, 1.18±0.55]. The difference was statistically significant (t =2.2377, P =0.0420, t =2.9352, P =0.0109, P <0.05). After treatment, CD+4 [Shenlu group:(37.9±5.9) %, Andriol group: (30.5±12.6) %] difference was statistically significant (t =2.1738, P =0.0474) in two groups; Shenlu group control abnormal expression of bone marrow cells, which were CD+13, CD+33, CD+34, CD+64,CD+117. The effect was better than Andriol group (the first three: u =2.76, u =3.39, u =2.85, P <0.01, the latter two: u =2.17, u =2.46, P <0.05). Conclusion clomplex Shenlu granule can effectively control normal hematopoietic function for MDS (RA/RCMD) due to kidney Yang deficiency.