| Objective: To observe and prove the clinical efficacy of TCM kidney-tonifying method in the therapy of patients with chronic aplastic anemia(CAA)by the distribution of TCM symptom,the improvement of blood routine(BR),and the expression of peripheral blood integrin ligand FN and VCAM-1 before and after treatment.Then,explore the basis of the difference between the kidney-yang deficiency and kidney-yin deficiency types,and the mechanism of the regulation of CAA hematopoietic adhesion by TCM kidney-tonifying method.Methods: 40 cases with CAA(20 cases of kidney-yang deficiency type and 20 cases of kidney-yin deficiency type)were collected according to CAA diagnosis,exclusion criteria and TCM syndrome classification criteria,then treated by TCM kidney-tonifying method combined with basic treatment for 6months.Observed and compared the general data of the patients,as well as the scores of TCM symptoms,blood cell analysis,and judge the efficacy after treatment;In addition,detected and compared the expression levels of peripheral blood FN and VCAM-1 before and after treatment by enzyme-linked immunosorbent assay(ELISA)and compared with 10 normal healthy cases.All the data was statistically analyzed using SPSS 22.0software,and P<0.05 as the significant difference,which was statistically significant.Results: The kidney-tonifying method was better for the treatment of CAA patients,the total clinical effective rate was 72.97%,and the total effective rate of TCM syndrome improvement was 91.89%.Self comparison in each kidney deficiency type group before and after treatment: The scores of TCM symptoms of two types group were both significantly decreased(P<0.05),and the blood cell analysis level were increased(P<0.05);Peripheral blood integrin ligand FN level were both decreased(P<0.05),and VCAM-1 level were both significantly increased after treatment(P<0.05);Comparison between the two kidney deficiency type groups: There was nostatistically significant difference in clinical effective and TCM effective rates between the two groups(P>0.05),however,the remission of total TCM symptom scores of kidney-yang deficiency type was better than kidney-yin deficiency(P<0.05);As for blood cell analysis,HGB value improvement of kidney-yang deficiency type was superior to kidney-yin deficiency type(P<0.05),moreover,the improve degree of PLT value of kidney-yang deficiency type better than kidney-yin deficiency(after treatment,comparison of two types' PLT baseline was P>0.05,whereas the difference value comparison P<0.05),and there was no significant variation in the improvement of WBC value of the two types(P>0.05);Additionally,before treatment,the FN levels of two types were significantly higher than the normal group(P<0.05),and VCAM-1 was significantly lower than the normal group(P<0.05);After treatment,both of the FN levels were decreased and VCAM-1 levels were increased in two types,nevertheless,two ligands expressions were still different from the normal group(P<0.05),in which FN expression of kidney-yang deficiency type was better than kidney-yin deficiency type(P<0.05),while,there was no significant difference in VCAM-1 expression between the two types(P>0.05),however,the degree of improvement of kidney-yang deficiency is better than kidney-yin deficiency(the difference value comparison P<0.05).Conclusion: TCM kidney-tonifying method can significantly and evidentially relief the TCM syndromes of CAA patients,up-regulate the baseline of BR,and has a definite clinical effect;Compared with the remission of TCM syndromes,the improvement of BR and laboratory indicators,kidney-yang deficiency type is better than kidney-yin deficiency type,which is shown a excellent drug-sensitivity;Meanwhile,this treatment method can reduce the level of integrin ligand FN and increase the expression of ligand VCAM-1 in CAA patients,which can regulate and restore the body's hematopoietic adhesion function and improve the hematopoietic capacity. |
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