| Polycythemia vera (PV) is a kind of acquired clonal disorder of the hemopoietic stem cell with proliferation of erythrocyte, included in the disorder of myeloprol-iferative diseases. PV may evolve into idiopathic myelofibrosis , myelodysplasia, and acute leukemia. PV has the clinic feature of long course, erythrocytosis and hypervo-lemia. PV has the main physical sign of purple skin, and splenomegaly.In TCM, there are many recorded symptoms and signs like PV. Blood stasis is regarded as the basic pathomechanism of PV. Many Chinese medicine herbs having the function to promote blood circulation and expel stagnation .have been verified they serve this function by inducing apoptosis. The apoptosis is induced by way of blocking cell cycle, decreasing expression of bcl-2mRNA which is a gene of inhibiting apoptosis, decreasing expression of mutant type pSSmRNA and effecting cytokines.Modern medicine has proved that BFU-E and CFU-E of PV is similar as or higher than normal level. Bone morrow culture in vitro or peripheral blood of PV conies to the conclusion that growth of BFU-E and CFU-E of PV does not depend on the level of extrinsic sero-Epo, which is named as "endogenous CFU-E" or "Epo-independent CFU-E". There is not obvious difference of Epo-mRNA expression between PV and normal people , neither gene mutation of Epo has been checked. The expression of bcl-2mRNA of culture of peripheral blood monokarocyte of PV patient without cytokine is higher than normal people.Diagnosis of PV is eliminative. Secondary polycythemia must be excluded. The aim of PV treatment is to decrease hypervolemia to relieve symptom and to prevent compli- cation from happening. Much attention has been paid on interferon because of its good curative effect, good last result and little side-effect.Apoptosis is a kind of dying way of cell under some certain physiological or pathologic condition. The essence of PV is that hemopoietic stem cell can not be induced apoptosis normally.Bcl-2 is related to apoptosis and is named as "existence-inducing gene" because it can inhibit apoptosis. P53 play vital part in cell division, differentiation and apoptosis, named as "police of gene" because it can induce apoptosis. P53 play vital part in checking Gl/S phase and G2/M phase. Whatever reason damages DNA, p53 block cell cycle at Gl phase and repair injured DNA. If DNA is hurt badly, p53 induce apoptosis.PV is a kind of syndrome of blood stasis. Modem medicine has proved abnormal4proliferation of hemopoietic stem cell of bone marrow is the basic pathomechanism of PV. Tablet xiaoyuling has function of promoting blood circulation to resolve stasis and dispersing abdominal massCruative effect is compared between TCM treatment and modem medicine on 10 patients by retrospective analysis. TCM treatment works a little bit later. Compared on eighth week, the effect of TCM treatment is the same as modern medicine(P>0.05). Side-effect is also compared and the conclusion is that the side-effect of TCM treatment is far littler than modem medicine (PO.05).8 PV patients treated by TCM are observed during 3 months and effective rate is 87.5%. Compared with data before treatment, amount of erythrocyte, hemoglobin and hematocrit decrease statistically significant (PO.05). The symptom score before treatment is 19.13?.36 while that after treatment is 14.63 ?.74, and the difference between two scores is significant statistically (P<0.05). The cardinal symptoms such as vertigo, thrombosis and the disorder of neuromuscular system are resolved significantly (PO.05), but bleeding and manifestations of tongue do not differ significantly (P>0.05), which maybe has something to do with abnormal function of platelet.The bone marrow of 5 patients out of 8 are polar hyperplasia, 2 patients are obvious proliferation and 1 patient is active proliferation before treatment, while 2 patients out of 8 are polar hyperplasia, 4 patients are obviously proliferative and 2 patient are activly proliferative after treatment. The difference is not significant stati...
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