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目的:观察温肾益髓法治疗肾阳虚型再生障碍性贫血(AA)的临床疗效,及对Th1/Th2和细胞因子的影响.方法:将符合要求的40例AA患者随机分为治疗组和对照组各20例,治疗组予中药联合西药治疗,对照组单用西药治疗.疗程均为6个月,观察2组临床疗效及治疗前后外周血细胞计数、Th1/Th2和细胞因子的变化.结果:治疗组临床疗效优于对照组,差异有统计学意义(P＜0.05);治疗组治疗后红细胞计数、血红蛋白含量均高于对照组,差异有统计学意义(P＜0.05,P＜0.01);与治疗前比较,治疗组CD4+IFN-y+细胞/CD4+细胞比例降低,差异有统计学意义(P＜0.01);TNF-α、IFN-γ较治疗前均明显降低,差异有统计学意义(P＜0.05);与对照组比较,IFN-y降低明显,差异有统计学意义(P＜0.01).结论:温肾益髓中药可提高肾阳虚型AA的治疗效果,其作用机制可能与减少Th1细胞的数量,调节Th1/Th2平衡,减少造血负调控因子TNF-α、IFN-y的分泌有关.“,”Objective:To observe the clinical efficacy of Wenshen Yisui Method for treating kidney-Yang deficiency aplastic anemia (AA) and its effect on Thl/Th2 and cell factor.Methods:40 AA patients met the requirement were randomly divided into 2 groups,20 cases in each one.One (treatment group) treated with Chinese and Western medicine,the other (controlled group) treated with only western medicine.The treatment lasted for 6 months.The blood cell counts,Th1/Th2 and cell factor changes before and after treatment in the two groups were observed.Results:The total effective rate of the treatment group was higher than the controlled group,and the two results had difference (P ＜ 0.05).After treatment,the red blood cell count and hemoglobin of treatment group were higher than before,with statistical significance (P ＜ 0.05,P ＜ 0.01).After treatment,The ratio of CD4+IFN-γ+ cell/ CD4+ cell in the treatment group were lower than before (P ＜ 0.05).After treatment,The TNF-α,IFN-γwere decreased more than before,among them,IFN-γ was decreased more than those of the controlled group (P ＜ 0.05).Conclusion:Wenshen Yisui Method can improve treatment efficacy for AA.The mechanism may be related to the decrease of Th1 cells,regulate the balance of Th1/Th2,and decrease TNF-αand IFN-γexudation.