| Objective: To observe the treatment of chronic aplastic anemia with Bushen Shengxue recipe and Yiqi Yangxue recipe combined with western medicine The clinical effect of anemia,CAA,hereinafter referred to as chronic aplastic anemia)and its influence on the levels of serum T-bet,GATA-3 and Th1 / Th2 were observed.The clinical value and safety were observed.This paper attempts to observe the possible factors related to the pathogenesis of aplastic anemia from the perspective of T cell subsets and gene transcription factors.Methods : According to the diagnostic criteria,40 CAA patients were randomly divided into treatment group(13 cases),control group 1(14 cases)and control group 2(13 cases).2.All the patients in the group were given Decoction free instant granules produced by Beijing kangrentang Pharmaceutical Co.,Ltd.the treatment group: Bushen Shengxue formula plus basic Western medicine;the control group 1: Yiqi Yangxue formula plus basic Western medicine;the control group 2: placebo plus basic Western medicine.One dose per day,twice in the morning and evening,each group was treated for 6 months.3.The main indexes of observation include: the total effective rate of 4-month and 6-month treatment,the curative effect of TCM syndrome,TCM symptom score,peripheral blood picture,the change of quality of life score and the occurrence of adverse reactions.4.Observation of laboratory indexes:(1)immunological indexes: flow cytometry was used to detect the changes of serum Th1 / Th2 levels in three groups before and after treatment;(2)gene indexes: RT-PCR was used to quantitatively detect the changes of serum T-bet and GATA-3 levels in three groups before and after treatment.Compared with 10 healthy people,the immune damage of chronic aplastic anemia patients was compared with that of healthy people.Results: A total of 40 cases were enrolled in the study,and one case in the control group fell off during the treatment.39 cases were actually completed.There were 13 cases in the treatment group,13 in the controlgroup and 13 in the control group.1.The total effective rate(ORR)of the three groups was 84.61% in the treatment group,69.23% in the control group and 53.85% in the control group.The overall effect of the treatment group is better than that of the control group 1 and 2(P<0.05);2.The TCM syndrome effect of the three groups: treatment group: 92.31%,control group 1: 76.92%,control group 2: 61.54%.The therapeutic effect of TCM syndrome in the treatment group was better than that in the control group 1 and 2(P<0.05);3.TCM symptom score before and after treatment in the three groups: TCM symptom score after treatment in the treatment group was significantly lower than that before treatment,and significantly better than that in the control group 1 and 2(P<0.05).4.Comparison of peripheral blood picture of the three groups: HGB,PLT,WBC and RBC levels of the three groups after treatment were higher than those before treatment,and the treatment group was significantly better than the control group one and the control group two(P<0.05).5.Comparison of serum T-bet,GATA-3 and Th1 / Th2 levels before and after treatment in three groups: after treatment,serum T-bet decreased,GATA-3 increased,Th1 / Th2 ratio decreased compared with that before treatment,the difference was statistically significant(P<0.05).The levels of T-bet,GATA-3 and Th1 / Th2 in the three groups before and after treatment were significantly higher than those in the healthy people(P<0.05);.6.Adverse reactions in three groups: during the treatment,ALT and AST increased slightly in three cases,and liver function returned to normal after regular liver protection treatment without adverse effects on the patients.Other safety indexes such as ECG,urine routine and stool routine were normal.Conclusion:1.The clinical effect of Bushen Shengxue formula combined with western medicine on CAA is better than that of Yiqi Yangxue formula combined with western medicine.2.Bushen Shengxue formula and Yiqi Yangxue formula combined withwestern medicine can improve the count level of HGB,RBC,WBC and PLT in the peripheral blood of CAA patients,but Bushen Shengxue formula is more effective than Yiqi Yangxue formula(P<0.05).3.Bushen Shengxue recipe can improve the immune state of Th1 / Th2 imbalance to a certain extent,reduce the high expression state of T-bet cell molecules,improve the expression level of GATA-3 cell molecules,reduce the negative regulatory factors of hematopoiesis,improve the immune function and promote hematopoiesis at the same time.4.Compared with healthy people,the serum T-bet level of aplastic anemia patients increased,the level of GATA-3 decreased,and the ratio of Th1 / Th2 increased,showing the dominant state of Th1.It is suggested that the incidence of aplastic anemia is related to the imbalance of Th1 / Th2 ratio and the abnormal number of specific cytokines. |
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