摘要
通过84例再生障碍性贫血的治疗观察,认为临床上以脾肾阳虚的患者所占比例较大,用温补脾肾代表方"二仙温肾汤"治疗的有效率达91.9%,治愈缓解率为50.0%,远期疗效也是可喜的。动物实验证实,二仙温肾汤能促进骨髓中多向性造血干细胞和红系、粒系祖细胞的增生;病理组织学观察认为,造血损伤中药组的骨髓充血、出血较对照组有所减轻,骨髓造血恢复也较对照组好。说明温补脾肾是治疗再障的一个重要法则。
84 cases observed were divided into 4 types according to principles of diagnosis and treatment based on an overall analysis of symptoms and signs,namely:Yang(阳)-deficiency of the Spleen and Kidney(62 cases,73.8%),Yin(阴)-deficiency leads to internal heat(6 cases),deficiency of both the Heart and the Spleen(7 cases),and prostration of Qi(气)after loss of blood(9 cases).The patients were treated with the method of warming and tonifying the Spleen and Kidney by using Er-Xian decoction of warming the Kidney(二仙温肾汤).The three other types were also treated with the method after being relieved with the methods of tonifying the Heart and the Spleen,of nourishing Yin to relieve internal heat and cooling blood,and of strengthening Yang to stop chronic hemorrhage respectively so that function of the blood and Qi would promote each other and be improved.The total effective rate was 84.5%,and remission rate was 47.6% among 84 cases,but 91.9% and 50.0% in the type of Yang-deficiency of the Spleen and Kidney alone.Among the effective cases there was a remarkable improvement in the hemogram after treatment(P<0.001,<0.01),and the long-termed curative effect was also exciting. The mechanism of Er-Xian decoction of warming the Kidneywas investigated through the nourishment of the hemopoiesis stem cell.The experiment showed that the decoction could increase CFU-S and GM-CFU in the bone marrow under the lower hemopoietic function of the bone marrow, and increase GM-CFU and CFU-E in the bone marrow of normal rats(P<0.001,<0.01,<0.05).The histological findings showed thatthere was a reduction in hemorrhage and hyperemia in the bone marrow between the decoction group and the control group,and the recovery of hemopoietic function was better than the latter.
