摘要
目的观察自拟补阴温阳汤治疗重型再生障碍性贫血患者的疗效及对外周血炎性因子、T淋巴细胞亚群和microRNA的影响。方法选取2015年1月—2018年10月于江苏省中医院血液科就诊的重型再生障碍性贫血患者78例作为研究对象,按照随机数字法则分为观察组和对照组各39例,另选取同期体检健康者30例作为正常对照组。对照组给予环孢素软胶囊和十一酸睾酮口服,观察组在对照组治疗基础上给予补阴温阳汤水煎服,2组均治疗6个月。对比观察组和对照组治疗疗效及3组间外周血炎性因子[白细胞介素-12p70(IL-12p70)、肿瘤坏死因子-α(TNF-α)、干扰素-γ(IFN-γ)、转化生长因子-β1(TGF-β1)]、T淋巴细胞亚群(CD3^+、CD4^+、CD8^+、B淋巴细胞、NK细胞所占比及CD4^+/CD8^+比值)、miR-155-5p和miR-1260b表达水平。结果观察组总有效率为64.1%(25/39),对照组为41.0%(16/39),观察组明显高于对照组(P<0.05)。治疗前,观察组和对照组患者外周血TNF-α、IFN-γ、IL-12p70、CD8^+和miR-155-5p、miR-1260b表达水平均明显高于正常对照组(P均<0.05),而TNF-β1、NK细胞、CD4^+水平以及CD4^+/CD8^+均明显低于正常对照组(P均<0.05);与治疗前相比,治疗后观察组和对照组患者外周血TNF-α、IFN-γ、IL-12p70、CD8^+和miR-155-5p、miR-1260b表达水平均明显降低(P均<0.05),而TNF-β1、NK细胞、CD4^+水平以及CD4^+/CD8^+均明显升高(P均<0.05),且观察组患者外周血TNF-α、IFN-γ、IL-12p70、CD8^+和miR-155-5p、miR-1260b表达水平均明显低于对照组,而TNF-β1、NK细胞、CD4^+水平以及CD4^+/CD8^+均明显高于对照组(P均<0.05)。结论补阴温阳汤治疗重型再生障碍性贫血疗效更为明显,其作用机制可能与改善T淋巴细胞亚群失衡,下调炎性因子和miR-155-5p、miR-1260b表达有关。
Objective It is to observe the curative effect of self-made Buyin Wenyang decoction on severe aplastic anemia and its influence on inflammatory factors,t lymphocyte subsets and microRNA in patients’peripheral blood.Methods 78 patients with severe aplastic anemia who visited our hospital’s hematology department from January 2015 to October 2018 were selected as the research objects.They were divided into two groups according to the random number rule,39 cases in each group.At the same time,30 healthy people who were examined in our hospital during the same period were selected as the normal control group.The control group was treated with western medicine only,namely oral ciclosporin soft capsule and testosterone undecanoate.The observation group was treated with Buyin Wenyang decoction on the basis of the control group.Both groups were treated for 6 months.The therapeutic effects in the control group and observation group and the peripheral blood inflammatory factors[Interleukin-12p70(IL-12p70),tumor necrosis factor-α(TNF-α),interferon-γ(IFN-γ),transforming growth factor-β1(TGF-β1)],T lymphocyte subsets(CD3^+,CD4^+,CD8^+,B lymphocytes,NK cells and CD4^+/CD8^+)l,miR-155-5p and miR-1260b in the three groups were compared.Results The total effective rate of the observation group was 64.10%(25/39),which was significantly higher than that 41.0%(16/39)of the control group(P<0.05).Before treatment,the levels of TNF-α,IFN-γ,IL-12p70,CD8^+,miR-155-5p and miR-1260b in the control group and observation group were significantly higher than those in the normal control group(P<0.05),while the levels of TNF-β1,NK cells,CD4^+,CD4^+/CD8^+in the two groups were significantly lower than those in the normal control group(P<0.05).Compared with before treatment,the expression levels of TNF-α,IFN-γ,IL-12p70,CD8^+and miR-155-5p and miR-1260b in the peripheral blood of observation group and control group after treatment were significantly reduced(all P<0.05),while TNF-β1,NK cells,CD4^+,CD4^+/CD8^+were significantly increa
作者
吴萸
朱光荣
WU Yu;ZHU Guangrong(Jiangsu Provincial Hospital of Traditional Chinese Medicine, Nanjing 210000, Jiangsu, China)
出处
《现代中西医结合杂志》
CAS
2020年第15期1603-1607,1611,共6页
Modern Journal of Integrated Traditional Chinese and Western Medicine
基金
江苏省中医药局科技项目(FY201702)。
