大黄䗪虫丸治疗JAK2-V617F阳性真性红细胞增多症的临床研究

邓来军; 董杨; 王翠; 孙伟国; 展昭民; 孙长岗

大黄䗪虫丸治疗JAK2-V617F阳性真性红细胞增多症的临床研究

1.
潍坊市中医院血液科，山东潍坊 261000
2.
潍坊市中医院临床药学科，山东潍坊 261000
3.
哈尔滨血液肿瘤研究所血液科，黑龙江哈尔滨 150000

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出版历程
- 刊出日期: 2020-11-10

Clinical Study of Dahuang Zhechong Pill in the Treatment of JAK2-V617F Positive Polycythemia Vera

1.
Department of Hematology, Weifang Hospital of Traditional Chinese Medicine, Weifang, 261000, China
2.
Department of Clinical Medicine, Weifang Hospital of Traditional Chinese Medicine, Weifang, 261000, China
3.
Department of Hematology, Harbin Institute of Hematologic and Oncology, Harbin, 150000, China

摘要

摘要: 目的观察大黄虫丸方治疗JAK2-V617F阳性真性红细胞增多症（PV）血瘀证的临床疗效，及对肿瘤血管新生相关因子表达水平的影响。方法收集患者43例，随机分对照组21例、治疗组22例，另收集10例免疫性血小板减少症患者作为空白组。对照组口服羟基酸，治疗组在对照组治疗基础上，加服大黄虫丸。治疗3个月后，应用骨髓增殖性肿瘤总症状评分表（MPN-SAF-TSS）、血瘀证证候积分表评估2组患者的临床疗效、不良反应及比较治疗前后骨髓威廉姆斯肿瘤基因（WT1）、血管内皮生长因子（VEGF）、环氧合酶-2（COX-2）、微血管密度（MVD）表达水平。结果治疗后治疗组MPN-SAF-TSS评估积分治疗后均下降（P<0.05～0.01），疲劳、体质量下降、腹部不适、注意力不集中、皮肤瘙痒、骨痛明显改善，优于对照组（P<0.05～0.01）。2组患者脉络瘀血、癥积、舌质症状改善明显（P<0.05～0.01），治疗组优于对照组（P<0.05）。2组有效率分别为77.3%、61.9%，治疗组优于对照组（P<0.05）。2组不良反应均无统计学差异（P>0.05）。与空白组比较，2组治疗前WT1、VEGF、COX-2、MVD表达均升高（P<0.05），治疗后均下降（P<0.05～0.01），治疗组WT1、VEGF、COX-2表达下降优于对照组（P<0.05）。结论大黄虫丸治疗PV有效，可抑制WT1基因表达，抑制肿瘤血管新生，且未见明显不良反应，值得进一步研究推广。
- 羟基脲 /
- 大黄虫丸 /
- 真性红细胞增多症 /
- 血管新生
Abstract: OBJECTIVE To observe the clinical efficacy of Dahuang Zhechong Pill in the treatment of blood stasis syndrome due to JAK2-V617F positive polycythemia vera (PV) and its influence on the expression of tumor angiogenesis-related factors. METHODS A total of 43 patients were enrolled and randomly divided into 21 cases in the control group and 22 cases in the treatment group. Ten patients with immune thrombocytopenia served as blank controls. The control group received oral hydroxyurea， and the treatment group was treated with Dahuang Zhechong Pills on the basis of the control group. After 3 months of treatment， applying the myeloproliferative neoplasms symptom assessment form total symptom score (MPN-SAF-TSS) and blood-stasis syndrome score form to evaluate the clinical efficacy and adverse reactions of patients in the two groups， as well as compare the indexes before and after treatment， including the expression levels of bone marrow Williams tumor gene (WT1)， vascular endothelium growth factor (VEGF)， cyclooxygenase-2 (COX-2) and microvessel density (MVD). RESULTS After treatment， the MPN-SAF-TSS evaluation scores of the treatment group decreased after treatment (P<0.05，P<0.01)， fatigue， weight loss， abdominal discomfort， inattention， skin itching， and bone pain were significantly improved， which were better than the control group (P<0.05，P<0.01). After treatment， the symptoms of blood stasis， concretion， and signs of tongue proper in the two groups were improved significantly (P<0.05，P<0.01)， and the treatment group was better than the control group (P<0.05). The effective rates of the two groups were 77.3% and 61.9%， respectively， and the treatment group was better than the control group (P<0.05). There was no statistical difference in adverse reactions between the two groups (P>0.05). Compared with the blank group， the expressions of WT1， VEGF， COX-2， and MVD in the two groups were high before treatment (P<0.05)， but lowered after treatment (P<0.05，P<0.01). The decreased levels of WT1， VEGF， COX-2 in the treatment group were better than those of the control group (P<0.05). CONCLUSION Quyu Liangxue prescriptions are effective in treating PV， and it can inhibit WT1 gene expression and tumor angiogenesis. There is no obvious adverse reaction， which is worthy of further research and promotion.
- hydroxyurea /
- Dahuang Zhechong pills /
- polycythemia vera /
- angiogenesis

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