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[目的]探讨复方中药清毒饮和养正片抗急性白血病的疗效机理。[方法]采用L7212白血病小鼠模型,用原位末端标记法(TUNEL)观察清毒饮(由七叶一枝花、白花蛇舌草、大青叶、山慈菇等组成)、养正片(由黄芪、人参、补骨脂、赤灵芝、三七片等组成)和足叶乙甙(VP16)化疗对L7212的白血病细胞凋亡的影响;用免疫组化法检测L7212白血病小鼠骨髓有核细胞的Fas基因表达;用酶联免疫吸附法(ELISA)检测可溶性Fas(sFas)。[结果]清毒饮组、养正片组、化疗组都可见较多凋亡阳性白血病细胞,清毒饮组优于养正片组,与化疗合用则更明显,凋亡指数均大于模型组(P<0.01);L7212白血病细胞Fas表达减低,给予清毒饮、养正片、化疗处理后Fas升高,清毒饮组亦较养正片组明显,清毒饮加化疗组则尤其明显(P<0.01);清毒饮组sFas较模型组明显降低(P<0.05),并接近正常空白组水平(P>0.05),养正片组则无明显变化。[结论]清毒饮、养正片能诱导L7212小鼠白血病细胞凋亡,并可促进化疗的诱导凋亡作用,以清毒饮尤为明显;清毒饮、养正片均能提高Fas的表达水平,清毒饮还可使L7212小鼠增高了的sFas水平降低。提示在急性白血病早期,采用祛邪攻毒中药可诱导其细胞凋亡并与化疗有协同作用;而此期采用扶正补虚中药则作用较差。
[Objective] To explore the curative effect mechanism of compound Chinese herbal medicine Qing Du Yin and Yang Zheng Tablet on acute leukemia. [Methods] L7212 leukemia mouse model was used to observe Qing Du Yin (composed of Aesculus japonicus, Hedyotis diffusa, Folium Isatidis, Cyperus rotundus, etc.) and Yang Zheng (by TUNEL). Effects of jaundice, ginseng, psoralen, Ganoderma lucidum, Sanqi tablets, etc. and VP16 chemotherapy on leukemia cell apoptosis in L7212; detection of bone marrow nucleated cells in L7212 leukemia mice by immunohistochemistry Fas gene expression; soluble Fas (sFas) detected by enzyme-linked immunosorbent assay (ELISA). [Results] There were more apoptosis-positive leukemia cells in Qingduyin group, Yangzheng tablet group and chemotherapy group. Qingduyin group was better than Yangzheng tablet group, and combined with chemotherapy was more obvious, and the apoptotic index was greater than that of model group (P). <0.01); Fas expression was decreased in L7212 leukemia cells and was increased after administration of Qingduyin, Yangzheng tablets and chemotherapy. The Qingduyin group was also more obvious than Yangshen tablet group, and Qingduyin plus chemotherapy group was especially significant (P<0.01). ); Qingdu Yin group sFas significantly lower than the model group (P <0.05), and close to the normal blank group level (P> 0.05), no significant changes in the positive film group. [Conclusion] Qingduyin and Yangzheng Tablets can induce apoptosis of leukemia cells in L7212 mice, and can promote the apoptosis-inducing effect of chemotherapy, especially for Qingdu Decoction; Qingduyin and Yangzheng Tablets can increase the expression level of Fas. Qingduyin also increased the increased sFas level in L7212 mice. It is suggested that in the early stage of acute leukemia, the use of Chinese herbal medicine can promote its apoptosis and has a synergistic effect with chemotherapy. In this period, the use of Fuzheng tonic Chinese medicine is less effective.