成人重型和输血依赖的非重型再生障碍性贫血中西医结合诊疗专家共识

通过组织全国中医血液病重点学科与重点专科建设单位部分专家讨论,就成人重型和输血依赖的非重型再生障碍性贫血的中西医结合诊疗方案达成一致意见并形成了较为完善的诊治规范体系。在再生障碍性贫血(简称"再障")诊断明确的前提下,对于成人重型再障(急髓劳病),有相合供者且条件适合者优先选择异基因骨髓移植,无相合供者首选强烈免疫抑制治疗与中医药的联合应用以截断细胞因子风暴;对于成人输血依赖的非重型再障(慢髓劳病)首选中医药与雄激素的联合应用以促进骨髓造血功能恢复。文章就再障的诊断与鉴别诊断、中医辨证论治、西医基础治疗等给予具体的诊治建议,以期为中西医结合诊疗再障提供指导和帮助。

Expert consensus for diagnosis and treatment of adult severe and transfusion-dependent non-severe aplastic anemia by the combination of traditional Chinese and Western medicine

The expert consensus of integrated traditional Chinese and Western medicine was reached on the diagnosis and treatment of adult severe and transfusion-dependent non-severe aplastic anemia,and the relatively mature standard system of diagnosis and treatment was formed,based on the discussion of several experts from constructing units of national hematological key disciplines and key specialties of traditional Chinese medicine(TCM).On the premise of confirmed diagnosis of aplastic anemia(AA),for adults with severe AA(acute myelopathy in TCM),allogeneic bone marrow transplantation is preferred for those with matched donor and suitable conditions,meanwhile it is the first choice for those without matched donors to adopt the combined regimen of intensive immunosuppressive therapy and TCM,in order to cut off cytokine storm.For adult transfusion-dependent non-severe AA(chronic myelopathy in TCM),the first choice is the combined therapy of TCM and androgen to promote the recovery of bone marrow hematopoietic function.In this paper,the specific diagnosis and treatment suggestions are proposed,including diagnosis and differential diagnosis of AA,TCM syndrome differentiation and treatment,basic treatment of western medicine,in order to provide guidance and help for the diagnosis and treatment of AA with integrated traditional Chinese and western medicine.