世界中医药

目的：观察复方皂矾丸对化学治疗所致粒细胞减少症临床疗效及部分机制研究。方法：将本院100例化学治疗所致粒细胞减少症患者纳入研究，随机分为对照组及观察组，各50例。2组患者均接受根据患者病情的不同，2组患者都予原发肿瘤疾病的常规护理及对症的基础治疗；对照组：在基础治疗的基础上加用重组人粒细胞集落刺激因子；观察组：在对照组的治疗方案基础上加用复方皂矾丸；1周为1个疗程，2组均接受为期2周的治疗。另外在本院体检中心随机抽取50例健康人作为健康对照组。治疗前，治疗后1周和治疗后2周，分别采血检测患者白细胞计数。治疗前和治疗后（此处指治疗2周后）利用酶联免疫吸附（ELISA）检测2组患者治疗前后外周血白细胞介素-23（IL-23）和白细胞介素-6（IL-6）的浓度变化。流式细胞仪检测辅助性T细胞17（Th17）；蛋白质印迹法（Western Blot）检测STAT3信号通路的激活情况。结果：1）与健康组比较，观察组、对照组均较低（P<0.05），然而治疗2周后，观察组已经接近正常白细胞指数的最低值4.0×109/L。观察组和对照组患者接受治疗措施后白细胞指数均有不同程度升高，其中观察组的提高值的幅度更大（P<0.05）。2）IL-23、IL-6、Th17和STAT3治疗后，观察组和对照组均比治疗前低（P<0.05），比健康对照组高（P<0.05）；治疗后，观察组Th17细胞占总T细胞（CD4）的百分比较对照组低（P<0.05）。结论：STAT3的过度激活是化疗所致粒细胞减少症患者的主要变化，复方皂矾丸抑制其磷酸化程度将是减少因其导致Th17转化率增加的现象，减少了因化疗导致T淋巴细胞功能亢进，纠正造血干细胞受损导致的粒细胞减少。

English Summary:

To observe the effect of compound Zaofan Pill on hemotherapy-induced granulocytopenia and part of its mechanism. Methods: One hundred patients with granulocytopenia induced by chemotherapy in our hospital were randomly divided into a control group and an observation group, each group of 50 cases. Two groups of patients were treated according to the patient’s condition, provided with basic routine treatment and nursing; the control group: basic treatment and recombinant human colony-stimulating factor; the observation group: basic treatment, recombinant human colony-stimulating factor and use of compound Zaofan pill; 1 week for a course of treatment, two groups were treated for 2 weeks. In addition, 50 healthy persons were randomly selected as the healthy control group. Before treatment, 1 week and 2 weeks after treatment, blood samples were collected from patients for white blood cell count. Before and after treatment （here means after 2 weeks of treatment）, peripheral blood interleukin-23 （IL-23） and interleukin-6 （IL-6） concentration changes of two groups of patients were tested by enzyme-linked immunosorbent assay （ELISA）. Flow cytometry was used to detect helper T cells 17 （Th17）. The activation of STAT3 signaling pathway was detected by Western blot. Results: 1） Compared with the healthy group, the observation group and the control group were lower （P<0.05）, but after treatment for 2 weeks, the observation group was close to the lowest value of normal white blood cell index （4.0×109/L）. The white blood cell index of the observation group and the control group were increased in varying degrees after treatment, in which the observation group increased more （P<0.05）. 2） IL-23, IL-6, Th17 and STAT3 after treatment in the observation group and the control group were lower than those before treatment （P<0.05）, and higher than those of the healthy control group （P<0.05）; after treatment, the percentage of Th17 cells in total T cells （CD4） of the observation group was lower than that of the control group （P<0.05）. Conclusion: The excessive activation of STAT3 is the main change in patients with granulocytopenia induced by chemotherapy, compound Zaofan Pill inhibit the phosphorylation level will be the reason of reduced conversion rate of Th17 increased, T lymphocyte hyperfunction caused by chemotherapy decreased, correcting hematopoietic stem cell damage caused by leukopenia.

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