69例再生障碍性贫血分型和中西医结合治疗的研究

取６９例再生障碍性贫血（再障）患者骨髓作红系祖细胞（ＢＦＵ－Ｅ、ＣＦＵ－Ｅ）和粒单祖细胞（ＣＦＵ－ＧＭ）培养，同时测定红系祖细胞对雄性激素的敏感性和单个核细胞（ＰＢＭＮＣ）对正常骨髓ＣＦＵ－ＧＭ的抑制率。６９例再障分成三型：干细胞缺乏型１０例，免疫介导型３０例和雄激素反应型２９例。按分型采取不同的中西医结合方案治疗，雄激素反应型主要用雄性激素和中药治疗，有效率高达９２．３％；免疫介导型中１７例谨慎使用免疫抑制剂和中药治疗，有效率为７０．６％；１０例于细胞缺乏型病情重，用综合治疗仅３例有效；５６例随访总有效率为７３．２％，以上结果提示针对分型治疗，可显著地提高疗效。

英文摘要:

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.

关闭