疏风凉血补肾方治疗慢性特发性血小板减少性紫癜临床研究(4)
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本研究表明,疏风凉血补肾方能够有效降低CITP患者升高的免疫学重要指标——PAIgG,从而减轻或消除免疫异常造成的巨核细胞分化成熟障碍和血小板破坏,使病情得以缓解、减轻,同时该方又能降低负性造血因子TGF-β1水平,从而减少该负性因子对骨髓巨核细胞分化成熟的抑制,促进骨髓巨核细胞分化成熟,这也应和该方的免疫调节作用相关。但同时我们推测是否也和该方可干预降低其他可能存在的非免疫因素导致的TGF-β1水平升高有关,有待今后更多的研究。
同时本研究观察到,疏风凉血补肾方单独应用或联合强的松应用对CITP的疗效及对CITP相关指标的调节要优于单纯应用强的松,我们考虑这是与纳入的病例较大部分是经强的松或其他免疫抑制剂久治无效而转诊有关,提示CITP发病是否可能还存在非免疫的因素,中医药可能对这部分发病的非免疫因素有较好的干预调节作用。
参考文献:
[1] 张之南.血液病诊断及疗效标准[M].3版.北京:科学出版社,2007:172-174.
[2] Jiang Y, LI J, Luo SK. Function of bone marrow hematopietic stem cells in patients with idiopathic thrombocytopenic purpura and its relationship with therapeutic outcome[J]. New Medical Journal, 2003,34(1):20-21.
[3] Mo Yang, Karen Li. The role of cytokines and transcription factors in megakaryocytopoiesis[J]. Journal Experimental Hematology, 2002,10(6):580-585.
[4] 胡涛,师晓东.人类巨核细胞的发育及成熟[J].中华儿科杂志,2005, 43(3):229-232.
[5] Majka M, Janowska-Wieczorek A, Ratajczak J, et al. Numerous growth factors, cytokines, and chemokines are secreted by human CD34+ cells, myeloblasts, erythroblasts, and megakaryoblasts and regulate normal hematopoiesis in an autocrine/paracrine manner[J]. Blood,2001,97(10):3075-3085.
[6] Lu L, Wang LS, Cooper RJ, et al. Suppressive effects of TNF-alpha, TGF-beta1, and chemokines on megakaryocytic colony formation in CD34+ cells derived from umbilical cord blood compared with mobilized peripheral blood and bone marrow[J]. J Hematother Stem Cell Res,2000,9(2):195-204.
[7] Sakamaki S, Hirayama Y, Matsunaga T, et al. Transforming growth factor-β induces thrombopoitin from bone marrow stromal cells, which stimulates the expression of TGF-β receptor on megakaryocytes and in turn, renders them susceptible to suppression by TGF-β itself with high specificity[J]. Blood,1999, 94(6):1961-1970.
[8] Kalina, Koschmieder S, Hofmann WK, et al. Transforming growth factor-beta1 interferes with thrombopoietin-induced signal transduction in megakaryo-blastic and erythroleukemic cells[J]. Exp Hematol,2001,29(5):602-608.
[9] 王璐,盛光耀,白松婷.骨髓转化生长因子-β1与巨核细胞转化生长因子β1Ⅲ型受体变化在特发性血小板减少性紫癜发病中的意义[J].实用儿科临床杂志,2005,20(11):1121-1122.
(收稿日期:2013-02-18,编辑:陈静)
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