中西医结合治疗对慢性再生障碍性贫血患者骨髓CD_(34)~+细胞凋亡的影响

目的　探讨中西医结合治疗慢性再生障碍性贫血 (CAA)的临床疗效及作用机理。方法将 79例CAA患者随机分为治疗组 (40例 )和对照组 (39例 )。对照组单用西药治疗 ,治疗组用补肾活血通络方加西药治疗。并分别于治疗前后采用免疫磁珠分离系统 (MACS)分离纯化骨髓CD3 4 + 细胞 ;用DNA末端原位标记 (TUNEL)技术分析骨髓CD3 4 + 细胞原位凋亡状况。结果　治疗组与对照组的基本治愈率、缓解率、总有效率分别为 37.50 %、2 5 .0 0 %、87.50 %和 2 0 .51 %、1 7.95 %、61 .54 %。 2组疗效比较有非常显著性差异 (P <0 .0 1 )。治疗前 2组骨髓CD3 4+ 细胞的凋亡率较健康组明显增高 (P <0 .0 1 ) ,治疗后治疗组骨髓CD3 4+ 细胞的凋亡率较治疗前明显降低 (P <0 .0 1 ) ,与对照组比较有非常显著性差异(P <0 .0 1 )。结论　中西医结合治疗CAA疗效高、毒副作用小。其作用机制可能是通过阻抑CAA患者造血细胞的过度凋亡 ,使骨髓造血功能重建

Effect of combined treatment of traditional Chinese and western medicine on the apoptosis of CD34+ cells in patients with chronic aplastic anemia

Objective To investigate the therapeutic effect of combined treatment of traditional Chinese and western medicine on chronic aplastic anemia (CAA) and to explore its mechanism.Methods 79 patients with CAA were randomly divided into two groups. 39 patients in control group were treated with western medicine;40 patients in treatment group were treated by combined treatment of traditional Chinese and western medicine. The bone marrow CD 34 + cells were isolated by MACS,and the in situ apoptosis of bone marrow CD 34 + cells was analyzed by TUNEL.Results The cure rate, remission rate and total effective rate in treatment group were 37.50%,25.00% and 87.50% respectively; those in control group were 20.51%,17.95% and 61.54% respectively. There was a significant difference between two groups (P<0.01). The apoptosis rate of bone marrow CD 34 + cells in treatment group after treatment was significantly decreased ,compared with that in control group (P<0.01).Conclusion The combined treatment of traditional Chinese and western medicine is effective in the treatment of CAA, with less side effects. The action mechanism may be inhibiting the apoptosis of hematopoietic cells and reconstructing hematopoietic function of bone marrow.