补髓生血颗粒治疗慢性再生障碍性贫血患者67例

目的:观察补髓生血颗粒治疗慢性再生障碍性贫血(CAA)患者的临床疗效及骨髓单个核细胞(BMNC)中Ras同源基因家族成员(Rho)-鸟苷酸三磷酸酶(GTP)相关酶类如细胞分裂周期蛋白(CDC42),Ras相关的C3肉毒杆菌毒素底物(Rac)以及Rho家族成员A(Rho A)的蛋白表达。方法:将134例CAA患者按随机数字表法分为试验组67例和对照组67例,另设20名健康志愿者作为正常对照组。试验组采用补髓生血颗粒治疗,对照组采用再造生血片治疗,两组疗程均为6个月。观察治疗前后临床疗效、中医症状积分、中医证候疗效、外周血、骨髓增生程度变化,采用Western-blot方法检测CAA患者治疗前后BMNC中Rho-GTP相关酶类(CDC42,Rho A,Rac)的蛋白表达。结果:试验组临床疗效及中医证候疗效均优于对照组(均P0.05);经治疗后,两组中医症状平均积分及外周血均明显改善(P0.05),试验组中医症状平均积分及外周血白细胞计数(WBC)及血红蛋白含量(HGB)的改善优于对照组(均P0.05),两组血小板计数(PLT)改善程度无显著性差异;两组骨髓象改善比较无显著性差异;两组治疗前CDC42,Rho A,Rac的相对蛋白含量表达均低于正常对照组(均P0.05),治疗后两组CDC42,Rho A和试验组中Rac的相对蛋白含量表达明显升高(均P0.05),而对照组中Rac的表达较治疗前无明显变化,两组治疗后CDC42,Rho A,Rac仍低于正常对照组(均P0.05),且试验组CDC42及Rac的表达改善优于对照组。结论:补髓生血颗粒治疗CAA疗效显著,且一定程度上能改善CAA患者的骨髓造血功能。CAA患者BMNC中Rho A,CDC42及Rac的蛋白均表达异常,提示Rho GTP酶异常表达可能与CAA发病相关,补髓生血颗粒可能通过调节Rho-GTP相关酶类CDC42,Rho A,Rac的表达来改善造血干细胞与造血微环境调节进而改善其骨髓造血功能。

Busui Shengxue Granule in Treating 67 Patients with Chronic Aplastic Anemia

Objective: To observe the curative efficacy of Busui Shengxue granule in treating chronic aplastic anemia (CAA) and its effect on protein expressions of Ras homologous members (Rho)-guanosine triphosphate (GTPase), such as cell division cycle 42 (CDC42), Ras-related C3 botulinum toxinsubstrate (Rac) and Ras homologous member A (Rho A) in bone marrow mononuclear cells (BMNC). Method: Totally 134 CAA patients were randomly divided into the test group (67 cases) and the control group (67 cases), and another 20 healthy volunteers were assigned into the normal control group. The test group was treated with Busui Shengxue granule, and the control group was treated with Zaizao Shengxue tablet;both groups were treated for 6 months. The changes in the clinical curative effect, score of traditional Chinese medicine (TCM) clinical symptoms, curative effect of TCM syndromes, peripheral blood and bone marrow hyperplasia degree were observed. The protein expressions of Rho-GTP-related enzymes (CDC42, Rho A and Rac) in BMNC of CAA patients were detected by Western-blot. Result: The test group showed better clinical curative effect and TCM syndrome curative effect than the control group (P <0.05). After the treatment, the average score of TCM clinical symptoms and peripheral blood of the two groups were significantly improved (P <0.05). The average score of TCM symptoms, white blood cell count (WBC) and hemoglobin (HGB) of the test group was better than that of the control group (P <0.05), but with no significant difference in the platelet count (PLT) between the two groups. The two groups showed no significant difference in the improvement of the bone marrow. Before the treatment, both groups showed lower relevant protein expressions of CDC42, Rho A and Rac the normal control group (P <0.05),whereas after the treatment,both groups showed significant increases in the relevant protein content of CDC42 and Rho A (P <0.05), but with no notable change in Rac expression in the test group compared with that before the treatment. After the treatment, the expressions of CDC42, Rho A and Rac in the two groups were still lower than that in the normal control group (P <0.05), and the expressions of CDC42 and Rac in the test group were better than that in the control group. Conclusion: Busui Shengxue granule has a significant effect in treating CAA, and can improve the hematopoietic function of bone marrow of patients with CAA. The abnormal expressions of Rho A, CDC42 and Rac in BMNC of CAA patients suggested that Rho-GTPases may be closely related with the pathogenesis of CAA. Busui Shengxue granule may improve hematopoietic stem cells, hematopoietic microenvironment and hematopoietic function of bone marrows by regulating the expressions of Rho-GTPases-CDC42, Rho A and Rac.