Study On The Therapeutic Effect And Demethylation Mechanism Of Qilian Yisui Qingdu Granule In The Treatment Of IPSS-R Low-risk Myelodysplastic Syndrome

Objective:Observing the efficacy of Qilian Yisui Qingdu Granules in treating myelodysplastic syndromes and its role in improving TCM syndromes,Western medical effects,peripheral blood and so on by conducting the clinical research.Through experimental studies,exploring the mechanism of Qilian Yisui Qingdu Granules on myelodysplastic syndrome from the perspective of molecular genetics.Methods:(1)Clinical study:30 patients with myelodysplastic syndrome that meet the diagnostic criteria were randomly divided into the observation/experimental groups and the control groups.The clinical efficacy of Qilian Yisui Qingdu Granule on myelodysplastic syndrome was analyzed by comparing the TCM syndrome score and peripheral blood images of the two groups;at the same time,SPSS 25.0 would be used for data analysis.(2)Experimental study:Collect the bone marrow samples of patients before and after treatment respectively as well as test the effect of Qilian Yisui Qingdu Granule on the expression of tet2 and IDH1 mRNA and DNA methylation in the bone marrow of the patients with myelodysplastic syndrome by PCR.Results:(1)Clinical study:In this study,30 MDS patients were randomly divided into observation/experimental group and control group,with 15 cases in observation/experimental group and 15 cases in control group.There was no significant difference in age,gender and risk score between the two groups before treatment(P>0.05).①TCM syndrome efficacy:The therapeutic effect of TCM syndrome in the observation/experimental group was 33.33%,40.00%and 26.67%respectively,while that in the control group was 13.33%,20.00%and 66.67%respectively.The difference-was statistically significant(P<0.05).②Compared with before treatment,the hemoglobin in the observation group was significantly higher,the difference was statistically significant(P<0.05).There was no significant difference between the two groups(P>0.05).③After treatment,by comparing the efficacy of Western medicine between the two groups of patients,the difference was not statistically significant(P>0.05).④There was no dramatic difference in safety indexes(P>0.05)(2)Experimental study:①This study examined the mRNA expression of TET2 and IDH1 in bone marrow mononuclear cells of MDS patients in the observation/experimental group before and after treatment as well as the normal control group.The results showed that the mRNA expression of TET2 and IDH1 in MDS patients was reduced compared with the normal control group.The difference was statistically significant(P<0.05).②After the treatment of Qilian Yisui Qingdu Granule,the positive rate of DNA methylation of tet2 decreased by 40.00%,and the positive rate of IDH1 DNA methylation decreased by 27.33%.The difference was statistically significant(P<0.05).Conclusion:By conducting clinical research,it can be seen that Qilian Yisui Qingdu Granules can reduce the TCM syndrome score of MDS patients,improve the TCM syndrome of patients,and obtain good TCM syndrome efficacy;at the same time,it can effectively improve hemoglobin and improve bone marrow hematopoiesis.Through experimental studies,it is known that Qilian Yisui Qingdu Granule can up-regulate the expression of TET2 and IDH1,and DNA demethylation may be its mechanism of action.