复方参鹿颗粒治疗肾阳虚型再生障碍性贫血疗效观察及对CD4T细胞亚群影响.docVIP

复方参鹿颗粒治疗肾阳虚型再生障碍性贫血疗效观察及对CD4T细胞亚群影响 　　摘要：目的 观察复方参鹿颗粒联合西药治疗肾阳虚型再生障碍性贫血（AA）临床疗效及对CD4+T细胞亚群的影响，探讨其作用机制。方法 将40例AA患者随机分为治疗组和对照组各20例。治疗组予复方参鹿颗粒联合西药治疗，对照组单用西药治疗。疗程均为6个月，随访1年以上。观察2组临床疗效及治疗前后外周血CD4+T细胞亚群变化。结果 治疗组临床疗效优于对照组，差异有统计学意义（P0.05）。治疗后2组血细胞计数均较治疗前改善，差异有统计学意义（P0.05，P0.01）。治疗组治疗后红细胞计数、血红蛋白含量均高于对照组，差异有统计学意义（P0.05）。与治疗前比较，治疗组治疗后CD4+CD25+细胞/CD4+细胞、CD4+CD25+FoxP3+细胞/CD4+CD25+细胞比例升高，Th1、Th2细胞比例降低，差异有统计学意义（P0.05）；对照组治疗后仅Th2细胞比例降低，差异有统计学意义（P0.05）。结论 复方参鹿颗粒可提高肾阳虚型AA治疗效果，其机制可能与减少Th1细胞数量、增加CD4+CD25+调节性T细胞数量、提高其FoxP3的表达有关。 　　关键词：复方参鹿颗粒；再生障碍性贫血；CD4+T细胞亚群 　　中图分类号：R259.565 文献标识码：A 文章编号：1005-5304（2016）05-0020-04 　　Efficacy Observation of Fufang Shenlu Granule for Kidney-yang Deficiency Aplastic Anemia and Its Effects on CD4+ T Lymphocyte Subsets ZHAO Lin， QIU Zhong-chuan， CHEN Pei， HUANG Zhong-di， HU Xiao-ying， ZHU Xiao-qin， QU Wei-ying （Shuguang Hospital Affiliated to Shanghai University of TCM， Shanghai 200021， China） 　　Abstract： Objective To observe the clinical efficacy of Fufang Shenlu Granule for kidney-yang deficiency aplastic anemia （AA） and its effects on CD4+ T lymphocyte subsets， and explore its mechanism. Methods Forty AA patients were randomly divided into treatment group and control group， 20 cases in each group. The treatment group was treated with Fufang Shenlu Granule combined with conventional western medicine therapy， while the control group was only treated with conventional western medicine therapy. The treatment lasted for 6 months， and follow-up visits lasted for at least one year. The clinical efficacy and T lymphocyte subsets ratio changes before and after treatment in the two groups were observed. Results The clinical efficacy of treatment group was better than that of control group （P 　　Key words： Fufang Shenlu Granule； aplastic anemia； CD4+ T lymphocytes subsets 　　再生障碍性贫血（aplastic anemia，AA）是免疫介导的以全血细胞减少为主要临床表现的骨髓衰竭性疾病。既往研究认为，CD8+T细胞介导的造血干细胞免疫损伤是AA发生的病理基础[1]。近年来研究发现，CD4+T细胞亚群在AA发病中发挥更重要的作用[2-3]。AA为临床常见的难治性血液系统疾病，中西医结合治疗该病的效果已得到认可。复方参鹿颗粒为本院院内制剂，该方重用温肾