Clinical Observation On The Treatment Of Non-severe Aplastic Anemia With Bushen Yisuishengxue Ointment And Analysis Of Mutation Landscape Of Peripheral Blood Mononuclear Cells In Patients With Aplastic Anemia

Objective: To observe the changes of TCM syndrome and peripheral hemogram before and after Bushen Yisui Shengxue ointment in the treatment of non-severe aplastic anemia,and to determine the clinical effect of Bushen Yisui Shengxue ointment.The whole exon sequencing was performed in patients with aplastic anemia to increase the understanding of the pathogenesis.Methods:A retrospective study was conducted and 40 patients with non-severe aplastic anemia were collected according to the standard of Naopai(observation group(n = 21)and control group(n = 19).The observation group was treated with Bushen Yisui Shengxue plaster combined with western medicine,and the control group was treated with western medicine only.After 6 months of treatment,the general data of the two groups were observed and evaluated,and the clinical efficacy was determined according to the TCM syndrome scores and peripheral hemogram before and after treatment.In addition,the peripheral blood of 19 patients with aplastic anemia were collected,and the mononuclear cells were extracted,the whole exons were sequenced,and the identified genes were analyzed by GO and KEGG enrichment analysis.The data were analyzed by SPSS 22.0 software,and the difference was statistically significant.Results: 1.Bushen Yisui Shengxue plaster is effective in the treatment of non-severe aplastic anemia,the clinical effective rate is 76.18%,and the effective rate of TCM syndrome improvement is 80.95%.2.Intra-group comparison of patients with non-severe aplastic anemia before and after treatment: the score of TCM syndrome decreased significantly,and the peripheral hemogram increased significantly;3.Compared with the control group,the observation group was superior to the control group in the improvement of TCM syndrome and the increase of peripheral blood HB value.4.There was no significant difference in the incidence of adverse reactions of Bushen Yisui Shengxue plaster in the treatment of non-severe aplastic anemia between Bushen Yisui Shengxue plaster and western medicine alone.A total of 2006 gene mutations were found in 5.19 patients with aplastic anemia,49 genes were screened according to Genecards and OMIM database and patient sequencing results,showing the landscape map of gene mutation in patients,it was found that MUC5 B may be related to the pathogenesis of aplastic anemia.6.In GO analysis,it is mainly related to cell movement,ligand and other functions.In the analysis of KEGG pathway,the highest enrichment degree is ECM-receptor interaction pathway,Hippo signal pathway and so on.Conclusion:Bushen Yisui Shengxue plaster can significantly improve the TCM syndrome of patients with non-severe aplastic anemia,improve the peripheral hemogram,and the clinical effect is obvious;we found that MUC5 B may be the key gene that causes T cell abnormality and lead to aplastic anemia,and we think that Hippo signal pathway may indirectly participate in the pathogenesis of aplastic anemia "kidney deficiency and myelasthenia",which provides reference for future research and treatment.