中国全科医学
中國全科醫學
중국전과의학
Chinese General Practice
2015年
27期
3360-3365
,共6页
唐振%李世杰%王颖飞%夏凯%侯晓利%张聪%叶震中%曹红春
唐振%李世傑%王穎飛%夏凱%侯曉利%張聰%葉震中%曹紅春
당진%리세걸%왕영비%하개%후효리%장총%협진중%조홍춘
环磷酰胺%化疗减毒汤%骨髓抑制
環燐酰胺%化療減毒湯%骨髓抑製
배린선알%화료감독탕%골수억제
Cyclophosphamide%Chemotherapy attenuation soup%Bone marrow suppression
目的：观察化疗减毒汤对环磷酰胺致骨髓抑制小鼠的保护作用，并探讨其机制。方法2013年9月2—21日，利用SPSS统计软件采用随机数字表法将60只小鼠随机分为6组，即对照组、模型组、重组人粒细胞集落刺激因子（G-CSF）组、化疗减毒汤低剂量组（10 g原生药/kg）、化疗减毒汤中剂量组（20 g原生药/kg）及化疗减毒汤高剂量组（30 g原生药/kg），每组10只。对照组给予低蛋白饲料；模型组给予低蛋白饲料并腹腔注射环磷酰胺；G-CSF组给予低蛋白饲料，腹腔注射环磷酰胺，皮下注射G-CSF；化疗减毒汤低、中、高剂量组给予低蛋白饲料，灌胃化疗减毒汤，腹腔注射环磷酰胺。末次给药后24 h 检测各组小鼠 IL -1α、IL-6水平、造血干细胞免疫表型（CD34-LSK）细胞占骨髓细胞百分比及外周血细胞数量〔红细胞（RBC）计数、血红蛋白（Hb）、白细胞（WBC）计数、血小板（ PLT）计数、中性粒细胞（ NEUT）计数、NEUT分数、淋巴细胞（ LYMPH）计数、LYMPH分数、单核细胞（ MONO）计数、MONO分数、嗜碱粒细胞（ BASO）计数、BASO分数、嗜酸粒细胞（ EO）计数、EO分数〕。结果模型组IL-1α水平、RBC、Hb、WBC、PLT、NEUT、LYMPH、LYMPH分数、EO 分数低于对照组， IL-6水平、CD34-LSK细胞占骨髓细胞百分比高于对照组（ P<0.05）；G-CSF组IL-6水平、CD34-LSK细胞占骨髓细胞百分比、NEUT分数、MONO分数高于对照组，RBC、Hb、LYMPH分数、EO分数低于对照组，IL-6水平、LYMPH分数低于模型组，WBC、NEUT分数高于模型组（ P<0.05）；化疗减毒汤低剂量组IL-1α水平、RBC、Hb、LYMPH分数、EO分数低于对照组，IL-6水平、CD34-LSK细胞占骨髓细胞百分比高于对照组，IL-6水平低于模型组，LYMPH高于模型组，LYMPH分数高于G-CSF组（P<0.05）；化疗减毒汤中剂量组RBC、Hb、LYMPH分数、EO分数低于对照组，WBC、NEUT、NEUT 分数高于对照组，IL -1α水平、WBC、PLT、NEUT、NEUT 分数、LYMPH 高于模型组， IL-6水平、CD34-LSK细胞占骨髓细胞百分比低于模型组，IL-6水平、CD34-LSK细胞占骨髓细胞百分比、MONO分数低于G-CSF组，WBC、LYMPH分数高于G-CSF组，IL-1α水平高于化疗减毒汤低剂量组，IL-6水平、CD34-LSK细胞占骨髓细胞百分比低于化疗减毒汤低剂量组（ P<0.05）；化疗减毒汤高剂量组RBC、Hb、LYMPH分数低于对照组，WBC、NEUT、NEUT 分数高于对照组，IL -1α水平、WBC、PLT、NEUT、NEUT 分数、LYMPH 高于模型组， IL-6水平、CD34-LSK细胞占骨髓细胞百分比低于模型组，IL-1α水平、WBC、LYMPH、LYMPH分数高于G-CSF组，IL-6水平、CD34-LSK细胞占骨髓细胞百分比、MONO分数低于G-CSF组，IL-1α水平、PLT高于化疗减毒汤低剂量组，IL-6水平、CD34-LSK细胞占骨髓细胞百分比低于化疗减毒汤低剂量组（ P<0.05）。结论化疗减毒汤中、高剂量具有很好的对抗环磷酰胺致骨髓抑制作用，在降低环磷酰胺对骨髓造血干细胞慢性毒性方面，化疗减毒汤优于G-CSF，其机制可能与调整IL-1α、IL-6水平、降低CD34-LSK细胞占骨髓细胞的百分比有关。
目的：觀察化療減毒湯對環燐酰胺緻骨髓抑製小鼠的保護作用，併探討其機製。方法2013年9月2—21日，利用SPSS統計軟件採用隨機數字錶法將60隻小鼠隨機分為6組，即對照組、模型組、重組人粒細胞集落刺激因子（G-CSF）組、化療減毒湯低劑量組（10 g原生藥/kg）、化療減毒湯中劑量組（20 g原生藥/kg）及化療減毒湯高劑量組（30 g原生藥/kg），每組10隻。對照組給予低蛋白飼料；模型組給予低蛋白飼料併腹腔註射環燐酰胺；G-CSF組給予低蛋白飼料，腹腔註射環燐酰胺，皮下註射G-CSF；化療減毒湯低、中、高劑量組給予低蛋白飼料，灌胃化療減毒湯，腹腔註射環燐酰胺。末次給藥後24 h 檢測各組小鼠 IL -1α、IL-6水平、造血榦細胞免疫錶型（CD34-LSK）細胞佔骨髓細胞百分比及外週血細胞數量〔紅細胞（RBC）計數、血紅蛋白（Hb）、白細胞（WBC）計數、血小闆（ PLT）計數、中性粒細胞（ NEUT）計數、NEUT分數、淋巴細胞（ LYMPH）計數、LYMPH分數、單覈細胞（ MONO）計數、MONO分數、嗜堿粒細胞（ BASO）計數、BASO分數、嗜痠粒細胞（ EO）計數、EO分數〕。結果模型組IL-1α水平、RBC、Hb、WBC、PLT、NEUT、LYMPH、LYMPH分數、EO 分數低于對照組， IL-6水平、CD34-LSK細胞佔骨髓細胞百分比高于對照組（ P<0.05）；G-CSF組IL-6水平、CD34-LSK細胞佔骨髓細胞百分比、NEUT分數、MONO分數高于對照組，RBC、Hb、LYMPH分數、EO分數低于對照組，IL-6水平、LYMPH分數低于模型組，WBC、NEUT分數高于模型組（ P<0.05）；化療減毒湯低劑量組IL-1α水平、RBC、Hb、LYMPH分數、EO分數低于對照組，IL-6水平、CD34-LSK細胞佔骨髓細胞百分比高于對照組，IL-6水平低于模型組，LYMPH高于模型組，LYMPH分數高于G-CSF組（P<0.05）；化療減毒湯中劑量組RBC、Hb、LYMPH分數、EO分數低于對照組，WBC、NEUT、NEUT 分數高于對照組，IL -1α水平、WBC、PLT、NEUT、NEUT 分數、LYMPH 高于模型組， IL-6水平、CD34-LSK細胞佔骨髓細胞百分比低于模型組，IL-6水平、CD34-LSK細胞佔骨髓細胞百分比、MONO分數低于G-CSF組，WBC、LYMPH分數高于G-CSF組，IL-1α水平高于化療減毒湯低劑量組，IL-6水平、CD34-LSK細胞佔骨髓細胞百分比低于化療減毒湯低劑量組（ P<0.05）；化療減毒湯高劑量組RBC、Hb、LYMPH分數低于對照組，WBC、NEUT、NEUT 分數高于對照組，IL -1α水平、WBC、PLT、NEUT、NEUT 分數、LYMPH 高于模型組， IL-6水平、CD34-LSK細胞佔骨髓細胞百分比低于模型組，IL-1α水平、WBC、LYMPH、LYMPH分數高于G-CSF組，IL-6水平、CD34-LSK細胞佔骨髓細胞百分比、MONO分數低于G-CSF組，IL-1α水平、PLT高于化療減毒湯低劑量組，IL-6水平、CD34-LSK細胞佔骨髓細胞百分比低于化療減毒湯低劑量組（ P<0.05）。結論化療減毒湯中、高劑量具有很好的對抗環燐酰胺緻骨髓抑製作用，在降低環燐酰胺對骨髓造血榦細胞慢性毒性方麵，化療減毒湯優于G-CSF，其機製可能與調整IL-1α、IL-6水平、降低CD34-LSK細胞佔骨髓細胞的百分比有關。
목적：관찰화료감독탕대배린선알치골수억제소서적보호작용，병탐토기궤제。방법2013년9월2—21일，이용SPSS통계연건채용수궤수자표법장60지소서수궤분위6조，즉대조조、모형조、중조인립세포집락자격인자（G-CSF）조、화료감독탕저제량조（10 g원생약/kg）、화료감독탕중제량조（20 g원생약/kg）급화료감독탕고제량조（30 g원생약/kg），매조10지。대조조급여저단백사료；모형조급여저단백사료병복강주사배린선알；G-CSF조급여저단백사료，복강주사배린선알，피하주사G-CSF；화료감독탕저、중、고제량조급여저단백사료，관위화료감독탕，복강주사배린선알。말차급약후24 h 검측각조소서 IL -1α、IL-6수평、조혈간세포면역표형（CD34-LSK）세포점골수세포백분비급외주혈세포수량〔홍세포（RBC）계수、혈홍단백（Hb）、백세포（WBC）계수、혈소판（ PLT）계수、중성립세포（ NEUT）계수、NEUT분수、림파세포（ LYMPH）계수、LYMPH분수、단핵세포（ MONO）계수、MONO분수、기감립세포（ BASO）계수、BASO분수、기산립세포（ EO）계수、EO분수〕。결과모형조IL-1α수평、RBC、Hb、WBC、PLT、NEUT、LYMPH、LYMPH분수、EO 분수저우대조조， IL-6수평、CD34-LSK세포점골수세포백분비고우대조조（ P<0.05）；G-CSF조IL-6수평、CD34-LSK세포점골수세포백분비、NEUT분수、MONO분수고우대조조，RBC、Hb、LYMPH분수、EO분수저우대조조，IL-6수평、LYMPH분수저우모형조，WBC、NEUT분수고우모형조（ P<0.05）；화료감독탕저제량조IL-1α수평、RBC、Hb、LYMPH분수、EO분수저우대조조，IL-6수평、CD34-LSK세포점골수세포백분비고우대조조，IL-6수평저우모형조，LYMPH고우모형조，LYMPH분수고우G-CSF조（P<0.05）；화료감독탕중제량조RBC、Hb、LYMPH분수、EO분수저우대조조，WBC、NEUT、NEUT 분수고우대조조，IL -1α수평、WBC、PLT、NEUT、NEUT 분수、LYMPH 고우모형조， IL-6수평、CD34-LSK세포점골수세포백분비저우모형조，IL-6수평、CD34-LSK세포점골수세포백분비、MONO분수저우G-CSF조，WBC、LYMPH분수고우G-CSF조，IL-1α수평고우화료감독탕저제량조，IL-6수평、CD34-LSK세포점골수세포백분비저우화료감독탕저제량조（ P<0.05）；화료감독탕고제량조RBC、Hb、LYMPH분수저우대조조，WBC、NEUT、NEUT 분수고우대조조，IL -1α수평、WBC、PLT、NEUT、NEUT 분수、LYMPH 고우모형조， IL-6수평、CD34-LSK세포점골수세포백분비저우모형조，IL-1α수평、WBC、LYMPH、LYMPH분수고우G-CSF조，IL-6수평、CD34-LSK세포점골수세포백분비、MONO분수저우G-CSF조，IL-1α수평、PLT고우화료감독탕저제량조，IL-6수평、CD34-LSK세포점골수세포백분비저우화료감독탕저제량조（ P<0.05）。결론화료감독탕중、고제량구유흔호적대항배린선알치골수억제작용，재강저배린선알대골수조혈간세포만성독성방면，화료감독탕우우G-CSF，기궤제가능여조정IL-1α、IL-6수평、강저CD34-LSK세포점골수세포적백분비유관。
Objective To observe the protective mechanism of chemotherapy attenuation soup for rats with cyclophosphamide - induced bone marrow suppression. Methods From September 2 to 21 in 2013, using SPSS statistic software,60 rats were equally divided into 6 groups:control group,model group,G -CSF group,low -dose chemotherapy attenuation soup group(10 g crude drug/kg),medium-dose chemotherapy attenuation soup group(20 g crude drug/kg)and high-dose chemotherapy attenuation soup group(30 g crude drug/kg). Control group was given low protein feed;model group was given low protein feed and cyclophosphamide by intraperitoneal injection;G - CSF group was given low protein feed, cyclophosphamide by intraperitoneal injection and G-CSF by subcutaneous injection;low-dose chemotherapy attenuation soup group,medium-dose chemotherapy attenuation soup group and high-dose chemotherapy attenuation soup group were given low protein feed,chemotherapy attenuation soup by gavage and cyclophosphamide by intraperitoneal injection. 24 hours after the last drug administration,examined levels of IL-1α and IL-6,percentage of CD34 -LSK cells in bone marrow cells,RBC,Hb, WBC,PLT,NEUT, NEUT score, LYMPH, LYMPH score, MONO, MONO score, BASO, BASO score, EO and EO score. Results Model group was lower ( P <0. 05 ) in the level of IL -1α, RBC, Hb, WBC, PLT, NEUT, LYMPH, LYMPH score,EO score and higher(P<0. 05)in the level of IL-6,percentage of CD34 -LSK cells in bone marrow cells than control group;G-CSF group was higher(P<0. 05)in the level of IL-6,the percentage of CD34 -LSK cells in bone marrow cells,NEUT score and MONO score and higher(P <0. 05)in RBC,Hb,LYMPH score and EO score than control group;G-CSF group was lower(P<0. 05)in the level of IL-6 and LYMPH score and higher(P<0. 05)in WBC and NEUT score than model group;low-dose chemotherapy attenuation soup group was lower(P<0. 05)in the level of IL-1α,RBC,Hb, LYMPH score and EO score and higher(P<0. 05)in the level of IL-6 and percentage of CD34 -LSK cells in bone marrow cells than control group;low-dose chemotherapy attenuation soup group was lower(P<0. 05)in the level of IL-6 and higher(P<0. 05)in LYMPH than model group;low-dose chemotherapy attenuation soup group was higher(P<0. 05)in LYMPH score than G-CSF group;medium-dose chemotherapy attenuation soup group was lower(P<0. 05)in RBC,Hb,LYMPH score and EO score and higher( P <0. 05 ) in WBC, NEUT and NEUT score than control group;medium - dose chemotherapy attenuation soup group was higher(P<0. 05)in the level of IL-1α,WBC,PLT,NEUT,NEUT score and LYMPH and lower (P<0. 05)in the level of IL-6 and percentage of CD34 -LSK cells in bone marrow cells than model group;medium-dose chemotherapy attenuation soup group was lower( P <0. 05 )in the level of IL-6 and percentage of CD34 -LSK cells in bone marrow cells and MONO score and higher( P <0. 05 ) in WBC and LYMPH score than G - CSF group;medium - dose chemotherapy attenuation soup group was higher(P<0. 05)in the level of IL-1α and lower(P<0. 05)in the level of IL-6 and percentage of CD34 -LSK cells in bone marrow cells than low - dose chemotherapy attenuation soup group;high - dose chemotherapy attenuation soup group was lower(P<0. 05)in RBC,Hb and LYMPH score and higher(P<0. 05)in WBC, NEUT score than control group;high-dose chemotherapy attenuation soup group was higher(P<0. 05)in the level of IL-1α, WBC,PLT,NEUT,NEUT score and LYMPH and lower(P<0. 05)in the level of IL-6 and percentage of CD34 -LSK cells in bone marrow cells than model group;high-dose chemotherapy attenuation soup group was higher( P<0. 05 )in the level of IL-1α,WBC,LYMPH and LYMPH score and lower(P<0. 05)in the level of IL-6,percentage of CD34 -LSK cells in bone marrow cells and MONO score than G-CSF group;high-dose chemotherapy attenuation soup group was higher( P<0. 05 )in the level of IL-1α and PLT and lower(P<0. 05)in the level of IL-6 and percentage of CD34 -LSK cells in bone marrow cells than low-dose chemotherapy attenuation soup group. Conclusion Medium-dose and high-dose chemotherapy attenuation soup have good protective effect against bone marrow suppression induced by cyclophosphamide. Chemotherapy attenuation soup is superior to G-CSF in reducing the chronic toxicity brought by cyclophosphamide in bone marrow hematopoietic stem cells. The mechanism is probably that it can adjust IL-1αand IL-6 levels and reduce the percentage of CD34 -LSK cells in bone marrow cells.
