补肾调和肝脾法对慢性再生障碍性贫血患者外周血单个核细胞端粒酶活性的影响

Effect of tonifying kidney and harmonizing liver and spleen on telomerase activity in peripheral blood mononuclear cells of patients with chronic aplastic anemia

关键词:  慢性再生障碍性贫血  补肾调和肝脾法  端粒酶活性

Key words:  chronic aplastic anemia  tonifying kidney and harmonizing liver and spleen  telomerase activity

摘要:

[目的] 观察补肾调和肝脾法治疗慢性再生障碍性贫血（CAA）的临床疗效，从外周血单个核细胞端粒酶活性的角度探讨其作用机制。[方法] 将92例CAA患者，采用随机数字表法随机分为治疗组和对照组，每组46例，对照组给予西药常规治疗，治疗组在对照组常规西药治疗基础上，加补肾调和肝脾中药，每日1剂，每剂分2次服，疗程均为6个月。评价临床疗效，并分别于治疗前后采用逆转录-聚合酶链反应（RT-PCR）法检测外周血单个核细胞端粒酶表达水平。[结果] 两组临床疗效比较有统计学意义（P<0.05），治疗组优于对照组。治疗组和对照组在治疗前后外周血象白细胞（WBC）、血红蛋白（HGB）、血小板计数（PLT）和TERT mRNA表达水平均具有统计学意义（P<0.05），治疗组在改善外周血象HGB、PLT和降低TERT mRNA表达水平均优于对照组，差异具有统计学意义（P<0.05），但治疗组在改善外周血象WBC方面与对照组相比差异不具有统计学意义（P>0.05）。[结论] 补肾调和肝脾法能够有效提高CAA患者的临床疗效，其作用机制可能与降低外周血单个核细胞端粒酶活性，参与造血干细胞的生成分化有关。

Abstract:

[Objective] To observe the clinical effect of tonifying kidney and regulating liver and spleen on chronic aplastic anemia (CAA), and explore the mechanism of telomerase activity in peripheral blood mononuclear cells.[Methods] The 92 cases of CAA were randomly divided into treatment group and control group, 46 cases in each group, the control group was given conventional western medicine treatment, the treatment group in the control group were treated with conventional therapy, plus Chinese medicine Bushen Tiaohe Ganpi, 1 dose daily, each agent taking 2 times. The average course of treatment was 6 months. The clinical efficacy was evaluated, and telomerase activity in peripheral blood mononuclear cells was detected by RT-PCR before and after treatment.[Results] The clinical curative effect of the two groups was statistically significant (P<0.05), the treatment group was better than the control group. The treatment group and the control group before and after treatment, peripheral blood white blood cell (WBC), hemoglobin (HGB), platelet count (PLT) and TERT mRNA expression levels were statistically significant (P<0.05), the treatment group in improving peripheral blood hemoglobin (HGB), platelet count (PLT) and the expression level of TERT mRNA was decreased better than the control group, the difference was statistically significant (P<0.05), but the treatment group in improve the peripheral blood leukocytes (WBC) compared with the control group the difference was not statistically significant (P>0.05).[Conclusion] Tonifying the kidney and harmonizing the liver and spleen can effectively improve the clinical efficacy of CAA, and its mechanism may be related to the decrease of telomerase activity in peripheral blood mononuclear cells and the formation and differentiation of hematopoietic stem cells.