Clinical Observation On Treatment Of Aplastic Anemia By TCM Kidney-tonifying Method And Qi-replenishing Method And Its Effect On Expression Of CD3~+HLA-DR~+ Cells

Objective:To observe the clinical efficacy of the TCM kidney-tonifying method and qi-replenishing method in the treatment of aplastic anemia(AA)and its influence on the level of CD3~+HLA-DR~+cells in peripheral blood.Methods:According to the AA diagnosis and inclusion and exclusion criteria,and the TCM syndrome classification criteria,53 AA patients were included.Using a random number table method,they were randomly divided into three groups(17 cases in the kidney-tonifying method group,20 cases in the qi-replenishing method group,16 cases in control group),then treated by TCM kidney-tonifying method and qi-replenishing method and and a placebo respectively,combined with conventional basic treatment for 6 months.Observe and compare the general data of the three groups of patients,the quality of life scores,TCM syndrome points,peripheral blood cell counts before and after treatment,and judge the efficacy after treatment.Observe and compare the general information,the quality of life scores,TCM symptom points,comparison of curative effects,peripheral blood cell count.CD3~+HLA-DR~+expression of the three groups before and after treatment were detected and compared,and compared with 10 healthy volunteers.In this study,SPSS 25.0 software was used for statistical analysis,and differences were considered statistically significant when P<0.05.Results:The kidney-tonifying method is better than that of the method of qi-replenishing method.The clinical effective rate was 94.12%,and the effective rate of TCM clinical effective rate was 88.24%.Comparison of the three groups of patients before and after treatment:the living quality scores were improved(P<0.05),the TCM syndromes scores were reduced(P<0.05),and the peripheral blood HGB,PLT,and ANC values were all improved(P<0.05).Comparison between the three groups of patients after treatment:the kidney-tonifying method was better in improving living quality scores(P<0.05);there was no statistical difference between the three group in the terms of TCM symptom improvement(P>0.05);the improvement in peripheral blood HGB and PLT values was better in the kidney-tonifying method group(P<0.05);compared with the improvement of peripheral blood ANC value,there was no significant difference between the kidney-tonifying method and blood-reducing method group in the terms of the ANC value improvement(P>0.05);The three groups of CD3~+HLA-DR~+cells levels in the serum before treatment were higher than those in the healthy volunteers(P<0.05).After treatment,those in three groups all decreased,but there is still a gap with the healthy control group(P<0.05).Meanwhile,kidney-tonifying method group is better than the qi-replenishing method group(P<0.05)in reducing of peripheral blood CD3~+HLA-DR~+cell leves.Conclusion:1.Both the kidney-tonifying method and the qi-replenishing method can improve the quality of life scores of AA patients,reduce TCM syndromes points,and increase the value of HGB,PLT and ANC of peripheral blood,and have significant clinical effects.2.The kidney-tonifying method is better than the qi-replenishing methodin improving the quality of life scores,peripheral blood HGB value,PLT value,and reduce the expression level of CD3~+HLA-DR~+in AA patients.3.The kidney-tonifying method can reduce the expression level of CD3~+HLA-DR~+cells in peripheral blood,and has the effect of regulating the immune function of the body.4.The expression level of CD3~+HLA-DR~+cells in the peripheral blood of AA patients increased than those in the healthy volunteers,indicating that the onset of AA may be related to the unbalanced expression of CD3~+HLA-DR~+ cells.