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目的观察补肾活血通络方联合免疫抑制剂治疗儿童再生障碍性贫血的临床疗效及对免疫因子的影响。方法将符合纳入标准的51例患儿随机分为治疗组和对照组,治疗组26例给予免疫抑制剂治疗,对照组25例在应用免疫抑制剂治疗的基础上联合补肾活血通络方治疗。治疗6月后,观察2组患儿的临床疗效,并检测外周血象、淋巴细胞亚群、γ-干扰素(IFN-γ)mRNA和白细胞介素-4(IL-4)mRNA的水平。结果治疗组总有效率为84.6%,对照组为68.0%,2组比较差异有统计意义(P<0.05);治疗后2组各项检测指标均较同组治疗前显著改善(P<0.05);治疗后与对照组比较,治疗组血红蛋白水平、白细胞计数及血小板计数显著升高,IFN-γmRNA和IL-4 mRNA相对表达量显著降低,2组比较差异有统计意义(P<0.05);治疗后2组患儿外周血淋巴细胞亚群均恢复至正常水平,与健康个体正常值比较差异均无统计意义(P>0.05),且治疗组恢复程度优于对照组(P<0.05)。结论补肾活血通络方联合免疫抑制剂治疗儿童再生障碍性贫血可以调节患儿机体的免疫功能,促进造血功能恢复,降低免疫因子水平,且优于单独使用免疫抑制剂。
Objective To observe the clinical efficacy of Bushen Huoxue Tongluo Recipe combined with immunosuppressive agents in the treatment of children with aplastic anemia and its effects on immune factors. Methods Fifty-one children who met the inclusion criteria were randomly divided into treatment group and control group. In the treatment group, 26 patients were treated with immunosuppressant and in control group, 25 patients were treated with immunosuppressive agent combined with Bushen Huoxue Tongluo Recipe. After 6 months of treatment, the clinical efficacy of the two groups were observed and the levels of peripheral blood, lymphocyte subsets, IFN-γ mRNA and interleukin-4 (IL-4) mRNA were detected. Results The total effective rate was 84.6% in the treatment group and 68.0% in the control group. The difference between the two groups was statistically significant (P <0.05). After the treatment, the detection indexes in both groups were significantly improved (P <0.05) Compared with the control group, the hemoglobin level, white blood cell count and platelet count of the treatment group were significantly increased after treatment, the relative expression of IFN-γ mRNA and IL-4 mRNA was significantly decreased in the treatment group (P <0.05) The peripheral blood lymphocyte subsets of the latter two groups recovered to normal levels, but the difference was not statistically significant (P> 0.05), and the recovery degree of the treatment group was better than that of the control group (P <0.05). Conclusion Bushen Huoxue Tongluo Recipe combined with immunosuppressive agents in the treatment of children with aplastic anemia can regulate the immune function, promote the recovery of hematopoietic function and reduce the level of immune factors in children, and is superior to immunosuppressive agents alone.