中医药治疗免疫性血小板减少症的机制

免疫性血小板减少症(immune thrombocytopenia,ITP)是一种免疫介导的血小板破坏增多、血小板生成不足,以皮肤黏膜出血为特征的自身免疫性疾病。现代中西医血液病专家共识将ITP的中医病名命名为"紫癜病"。ITP的中医病因复杂,外感内伤均可致病,病机主要为外感邪热,血热妄行;脾气虚损,气不摄血;肝肾阴虚,虚火上炎;瘀血内阻,血不循经。近年来研究表明,从中医临床实践到实验研究,中医药在治疗ITP的作用机制上取得了一些进展,包括抑制血小板相关抗体的产生,减少血小板的破坏及改善血小板功能;促进巨核细胞成熟及血小板生成增多;调节细胞免疫及体液免疫,使其紊乱的免疫功能恢复平衡。本文就中医药干预ITP的临床及实验研究进行总结分析,为评价中医药治疗ITP的作用机制及新药研发提供参考。

Mechanism of Traditional Chinese Medicine in Treatment of Immune Thrombocytopenia

Immune thrombocytopenia (ITP) is an immune-mediated disorder characterized by increased platelet destruction and decreased platelet production and mucocutaneous bleeding. Traditional Chinese and western medicine hematology experts reached the consensus to name the disease as "purpura disease". The traditional Chinese medicine (TCM) etiology of ITP is complex, including exogenous and internal injuries.The TCM pathogenesis are mainly exogenous pathogenic heat, hemopyretic bleeding, spleen Qi deficiency, Qi dysfunction in blood control, liver-kidney Yin deficiency, flaring up of deficient fire, stagnation of blood stasis, failure of blood to circulate in vessels. In recent years, clinical and animal experimental researches have showed some progress in the mechanism of TCM in the treatment of ITP, including inhibition of platelet associated antibody production, reduction of platelet destruction and improvement of platelet function, promotion of maturation of megakaryocytes and increase in platelet production; regulation of cell immunity and humoral immunity, and restoration of immune function from disorder to balance. In this paper, clinical and experimental studies on TCM in the treatment of ITP were analyzed and summarized to provide a reference for the evaluation of the mechanism of TCM in the treatment of ITP and the new drugs research and development.