Akinsulie A O, Temiye E O, Akanmu A S, Lesi F E A, Whyte C O
Department of Paediatrics, College of Medicine of University of Lagos (CMUL), Nigeria.
J Trop Pediatr. 2005 Aug;51(4):200-5. doi: 10.1093/tropej/fmh097. Epub 2005 May 25.
The major pathology in sickle cell anaemia (SCA) is sickling of red cells due to the precipitation of reduced haemoglobin. We report our experience with extract of Cajanus cajan as a possible antisickling agent by determining changes, if any, in clinical and laboratory features of the disease in patients given the extract in a single-blind placebo-controlled study. One hundred patients with steady-state SCA were randomized into treatment and placebo arms. The extract/placebo were administered twice daily to the subjects. Weight, hepatosplenomegaly, blood levels of biliurubin, urea, creatinine, and packed cell volume (PCV) were monitored over a 6-month period. Recall episodes of pain 6 months before enrolment were compared with episodes of pains recorded during the treatment period. Twenty-six cases (55.3 per cent) had hepatomegaly on enrolment. This significantly reduced to 33.3 per cent at 6 months (p = 0.03); but increased in the placebo arm (p > 0.05). The total number of recall painful episodes in cases was 207 (mean 4.4 +/- 10.3 (SD), range 0-60) and fell to 191 (mean 4.2 +/- 4.4 (SD), range 0-16); p = 0.03. Episodes of pain increased from 109 in controls (mean 2.6 +/- 5.0 (SD), range 0-26) to 164 (mean 3.9 +/- 4.3 (SD), range 0-22); p = 0.01. Mean PCV in the cases showed no appreciable changes (p = 0.1) but there was a significant increase in the controls (p = 0.02). In conclusion, the extract may cause a reduction of painful crises and may ameliorate the adverse effects of sickle cell anaemia on the liver. The mechanism of action remains to be determined.
镰状细胞贫血（SCA）的主要病理表现是由于还原血红蛋白沉淀导致红细胞镰变。在一项单盲安慰剂对照研究中，我们通过确定给予提取物的患者疾病临床和实验室特征的变化（如有），报告了木豆提取物作为一种可能的抗镰变剂的经验。100例病情稳定的SCA患者被随机分为治疗组和安慰剂组。提取物/安慰剂每日两次给予受试者。在6个月期间监测体重、肝脾肿大、胆红素、尿素、肌酐的血药浓度以及红细胞压积（PCV）。将入组前6个月的疼痛发作情况与治疗期间记录的疼痛发作情况进行比较。26例（55.3%）患者入组时存在肝肿大。6个月时这一比例显著降至33.3%（p = 0.03）；但安慰剂组有所增加（p > 0.05）。病例组回忆起的疼痛发作总数为207次（平均4.4 +/- 10.3（标准差），范围0 - 60），降至191次（平均4.2 +/- 4.4（标准差），范围0 - 16）；p = 0.03。对照组的疼痛发作从109次（平均2.6 +/- 5.0（标准差），范围0 - 26）增加到164次（平均3.9 +/- 4.3（标准差），范围0 - 22）；p = 0.01。病例组的平均红细胞压积无明显变化（p = 0.1），但对照组有显著增加（p = 0.02）。总之，该提取物可能会减少疼痛危象，并可能改善镰状细胞贫血对肝脏的不良影响。其作用机制仍有待确定。
