| Objective:According to the traditional Chinese medicine(TCM)theory of "the kidney being in charge of the bone,storing the essence of life,nourishing the bone marrow and the essence of life transforming into blood ",the project is to observe the clinical efficacy of nourishing marrow and engendering blood capsule combined with cyclosporine A(CSA)and stanozolol in the treatment of chronic aplastic anemia(CAA),and the effects of IL-4,IL-27 and TNF-α levels in peripheral blood,and to explore the effect and possible mechanism of Ch inese patent medicine nourishing marrow and engendering blood capsule with the function of "tonifying kidney and filling essence,reinforcing qi and nourishing blood" on CAA.Methods:From April 2017 to June 2018,among the patients in the Department of Hematology,Henan Province Hospital of Traditional Chinese Medicine,64 patients with chronic aplastic anemia were randomly divided into two groups.The control group was given CSA+stanozolol,while the test group was given nourishing marrow and engendering blood capsule on the basis of the control group.Give symptomatic supportive treatment if necessary.Observe and record the blood cell count s,IL-4,IL-27,TNF-α of patients in the 3rd and 6th month after treatment,and evaluate the efficacy and TCM symptom scores of the two groups,as well as monitor the liver and kidney function of the patients.Four patients were excluded.Results:1.The medical efficacy of Chinese medicine in the test group and the control group: Total effective rate of the test group:93.33%,clinical recovery:16.67%,markedly effective:46.67%,effective:30%.Total effective rate of the control group:73.33%,clinical recovery:6.67%,markedly effective:30%,effective: 36.67%.There was a difference in the total effective rate between the two groups(P<0.05),which was statistically significant.The comparison of symptom scores between two group: There was no difference in symptom scores between the two groups before treatment(P>0.05),which was no statistical significance.There were differences in the 3rd and 6th months after treatment(P<0.05),which was statistically significant,and the symptom scores of the test group were lower than those of the control group..After treatment,the symptom scores of both groups showed a downward t rend,and the test group showed a more significant downward trend.2.The medical efficacy of the test group and the control group: 1 case was cured in the test group,7 cases were relieved,19 cases were obviously improved,and 3 cases were ineffective.In the control group,0 cases were cured,6 cases were relieved,16 cases were obviously improved,and 8 cases were ineffective.The number of invalid cases in the test group was smaller than that in the control group;there was no difference in the efficacy and total effective rate between the two groups(P>0.05),which was not statistically significant.3.Comparison of white blood cells(WBC),hemoglobin(HGB)and platelet(PLT)at different time points in the test group and the control group: There was no difference in the comparison between WBC,HGB and PLT before treatment(P>0.05),no statistics significance.The differences of HGB and PLT between the two groups in the 3rd and 6th month after treatment were statistically significant(P<0.05),HGB and PLT of the test group were higher than those of the control group;while the differences of WBC between the two groups in the 3rd and 6th month after treatment were not statistically significant(P>0.05);Compare WBC before treatment and in the 6th month after treatment,there were differences in the two groups,which were statistically significant(P<0.05).Compared prior treatment with the 3rd month after treatment,the 3rd month with the 6th month after treatment,there was no difference of WBC in the two groups(P>0.05),no statistical significance.There were differences in HGB and PLT in the two groups(P<0.05)before treatment,after the 3rd and the 6th month’s treatment,which was statistically significant.After treatment,WBC、HGB and PLT of both groups showed an upward trend.4.Comparison of IL-4,IL-27 and TNF-α at different time points in the test group and the control group: There was no difference in IL-4 between the two groups before treatment and at the 3rd and 6th month after treatment(P>0.05).which was no statistical significance.There was no difference in TNF-α between the two groups before treatment and at the 3rd month after treatment(P>0.05),which was no statistical significance.There was a difference in TNF-α between the two groups at the 6th month after treatment(P<0.05),which was statistically significant,and TNF-α of the test group was lower than that of the control group.There was no difference in IL-27 between the two groups before treatment(P>0.05),with no statistical significance.There were significant differences in IL-27 between the two groups at the 3rd and 6th months after treatment,which were statistically significant(P<0.05),and IL-27 of the test group was lower than that of the control group.There were differences in IL-4 in the two groups before treatment and at the 6th month after treatment(P<0.05),which were statistically significant.Compared prior treatment with the 3rd month after treatment,the 3rd month with the 6th month after treatment,there was no difference in the IL-4 in the two groups(P>0.05),no statistical significance.There were differences in IL-27 and TNF-α in the two groups(P<0.05)before treatment,after the 3rd and 6th month’s treatment,which was statistically significant.After treatment,the plasma level of IL-4 of both groups showed an upward trend,and those of IL-27、TNF-α of both groups showed a downward trend.5.There was no obvious abnormality of liver and kidney function in the two group during the observation period.Conclusion:1.Nourishing marrow and engendering blood capsule can improve the peripheral blood cells and TCM symptoms of CAA patients.2.Nourishing marrow and engendering blood capsule can regulate the concentration of IL-4,IL-27 and TNF-α in plasma of CAA patients,which indicates that the medine can play a role in the treatment of aplastic anemia by regulating peripheral blood hematopoietic cytokines,but the effect of increasing IL-4 is weak.3.Nourishing marrow and engendering blood capsule is safe and effective. |
PDF Full Text Request