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69例再生障碍性贫血中西医结合分类与治疗研究

[A study of classification and treatment of combined traditional Chinese medicine and Western medicine of 69 cases of aplastic anemia].

作者信息

Yu R X, Luo X S

机构信息

Zhejiang Hospital of TCM, Hangzhou.

出版信息

Zhongguo Zhong Xi Yi Jie He Za Zhi. 1994 Jan;14(1):14-7, 3.

PMID:8043994
Abstract

Hemopoietic progenitor cells (BFU-E, CFU-E and CFU-GM) of 69 cases of aplastic anemia were cultured in vitro while the sensitivity of CFU-E and BFU-E to androgen was assayed. The suppressive effect of peripheral blood mononuclear cell (PBMNC) from patients on normal CFU-GM growth was also studied. Hence 69 cases of aplastic anemia were divided into three types: 10 cases of stem cell deficiency type, 30 cases of immuno-mediated type and 29 cases of androgen response type. According to above classification, different treatment programs were practiced using both TCM and western medicine. In the androgen response type, androgen and TCM were used and the effective rate reached 92.3%. In the immuno-mediated type, in addition to TCM. Immunosuppressive agents were cautiously used and the effective rate was 70.6%. As for the stem cell deficiency type, 10 patients' conditions were usually very severe so comprehensive therapeutical means were adopted and 3 cases were improved. The overall response rate of these three was 73.2%. These results showed that the treatment program under the direction of classification have greatly improved the curative effect.

摘要

对69例再生障碍性贫血患者的造血祖细胞(爆式红系集落形成单位、红系集落形成单位和粒-巨噬系集落形成单位)进行体外培养,同时检测红系集落形成单位和爆式红系集落形成单位对雄激素的敏感性。还研究了患者外周血单个核细胞对正常粒-巨噬系集落形成单位生长的抑制作用。据此将69例再生障碍性贫血患者分为三型:干细胞缺陷型10例、免疫介导型30例、雄激素反应型29例。根据上述分型,采用中西医结合的不同治疗方案。在雄激素反应型中,使用雄激素和中药,有效率达92.3%。在免疫介导型中,除中药外,谨慎使用免疫抑制剂,有效率为70.6%。至于干细胞缺陷型,10例患者病情通常非常严重,因此采用综合治疗手段,3例病情好转。这三型的总有效率为73.2%。这些结果表明,在分型指导下的治疗方案大大提高了疗效。

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