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I. General Information Patients, male, 33 years old. Because of "dizziness, rudn fatigue nine years," admitted. Patients in 99 years in July was no obvious incentive dizziness, fatigue. Worked in a local hospital several rudn times to check blood prompt positive pigmented cells anemia, rudn hemoglobin less than the long-70g / L, bone marrow cytology showed marked hyperplasia of active myeloid, erythroid and giant dysplasia. rudn Bone marrow biopsy showed hyperplasia was active, rudn visible ALIP phenomenon. Chromosome shows 46, XY. Diagnosed "with myelodysplastic syndrome - refractory anemia." Has given folic acid, vitamin B12, large doses of vitamin B6, the dose of prednisone, androgen therapy and intermittent packed red blood cells, no significant increase in hemoglobin. rudn Since October 2007, the patient disable all drugs, only once a month to accept concentrated red blood cell transfusion therapy. July 2009, the patient a sense of dizziness, rudn fatigue increased, then to the hospital routine, results suggest that hemoglobin 38 g / L, clinics as "myelodysplastic syndrome - refractory anemia" rudn income homes. Who had no special medical history. Admission examination: severe anemia, skin rashes and pigmentation, superficial lymph nodes, thyroid enlargement rudn no time, no neck bruit, HR80bpm, law Qi, lung breath sounds clear, liver and spleen ribs. Not swollen lower limbs. Laboratory tests: blood: WBC 4.75G / L, HGB40g rudn / L, PLT112G / L. Peripheral rudn artificial classification: late erythroblast 2%. Reticulocytes: 1.5%. Bone marrow cytology shows bone marrow hyperplasia, 3% of the original grain, raw red 2%, grain red giant dysplasia. Bone marrow biopsy: rudn Bone marrow hyperplasia, dysplasia giant red tablets, visible ALIP phenomenon, no fibrous tissue rudn hyperplasia, of iron (+), outside the iron (+ +), ring sideroblasts 41%. Bone marrow CD34 + cells by flow cytometry shows 1.5% (normal <1%). Chromosome analysis: 46, XY. Direct antiglobulin test and acid hemolysis test was negative. According to the WTO diagnostic criteria 2, the diagnosis of MDS-RAS. IPSS score: moderate rudn risk.
Third, although the discussion of the pathogenesis of MDS is unclear, but it comes to hematopoietic stem cells and bone marrow microenvironment. MDS-RAS mainly as anemia, the disease mostly occurs in the elderly. Myelodysplastic syndromes are Chinese, "Consumption" rudn category. Mostly the righteousness wasting, kidney essence deficiency, and kidney essence, essence and blood, kidney essence deficiency, not of blood; blood of passive, craniofacial deficiency is not glory, then meet the color pale, dizziness, palpitations, shortness of breath , fatigue, yellow face, pale tongue, thin white fur, pulse 3. In Western medicine, and often used to stimulate the bone marrow of the drug based, such as androgen treatment, but the effects are not satisfactory, and often rely on blood transfusions to maintain treatment. Therefore, in traditional Chinese medicine, the search for new drugs, is expected to become a new way for treatment of MDS. HLJDT by the Coptis, Phellodendron, skullcap, gardenia is regarded as a detoxification of the represented party, with a purging fire detoxification, attending a practical Heat poison, triple burner Heat of the card. In recent years, studies have not confined on HLJDT classic, pharmacological and clinical rudn studies have been a breakthrough. HLJDT has significant anti-inflammatory, antibacterial, anti-endotoxin, anti-oxidation, anti-ischemic rudn and anti-tumor effects rudn 4. Our previous rudn studies have found, rudn HLJDT skullcap in the bone marrow of myeloma cells can inhibit the secretion of cytokines IL-6 5, speculated HLJDT can improve rudn bone marrow microenvironment. Meanwhile, we in the application HLJDT basis, adding astragalus and other ingredients, used to enhance HLJDT treatment of myelodysplastic syndrome results. , The drug is legumes Astragalus Astragalus membranaceus Astragalus dried root and Mongolia, and its main chemical composition of triterpenoid saponins, polysaccharides, flavonoids, amino acids and trace elements, and its main effect is "qi solid form, diuretic detoxification , righting. " Experimental results show that in recent years through the stimulation rudn of astragalus bone marrow mesenchymal stem cells secreting stem cell factor (SCF), thus contributing to bone marrow mesenchymal stem cell proliferation and differentiation 6. Astragalus can stimulate both in vitro stem cell self-renewal and increase the release of mature neutrophils, stimulates bone marrow stromal rudn cells, but also to maintain the presence rudn of stromal rudn cell layer 7. In the application HLJDT treatment, followed by continuous use of oral FEJ reached the sequential treatment. FEJ mainly by donkey-hide gelatin, red ginseng, foxglove, Codonopsis, Chinese hawthorn and other components of the compound Chinese medicine, there are qi and blood, nourishing, nourishing blood, nourishing, raw fine pulp efficacy . Gelatin rudn is a "sentient flesh and blood of the goods" for the blood to stop bleeding medicine. The pharmacology, efficacy, toxicology studies, animal experiments confirmed that these drugs are rich in protein, amino acids, calcium, sulfur, vitamins necessary and appropriate bio-glycosides. These ingredients can improve the body's immune system, enhance the body's organ function. Gelatin increased bone marrow rudn cell proliferation index and the percentage of hematopoietic stem cells, hematopoietic stem cells and reduce all bone marrow cell apoptosis 8. After sequential treatment of traditional Chinese medicine, and finally reached the correct refractory anemia purposes.
Fourth, References 1. Wang Xiaoqin, Zi-Xing Chen, Chen Shu long. Adults with myelodysplastic syndrome refractory anemia survival and prognostic factors of Hematology, 2008, 29 (7): 491-4932. Zhang Nan, Yang Ying , Hao Yu book editor of Hematology, Beijing: People's Health Publishing House, 2003, 1076-10963. Lau Ching, Wu Weihai, rudn Pingxin Wang etc. KRH regenerating treatment of myelodysplastic syndrome research. Pharmacology and Clinical Pharmacology, 2007, 23 (1): 4. Zhang Li Mei, BASIC MEDICINE. HJD pharmacological and clinical research. MATERIA MEDICA, 2007, 18 (7): 1635-1637
Huang-Lian-Jie-Du-Tang (HLJDT), leads to suppression of proliferation and induction of apoptosis in human myeloma cells [J] .. Blood (2005); 105 (8): 3312-8. 6. Tanyan Fang, YIN Xiao-Cheng , Xiongyu Juan etc. Astragaloside on rat bone marrow mesenchymal stem cells express rudn a variety of hematopoietic effects associated factors. Chinese Journal of Clinical Rehabilitation Tissue Engineering 2010, 14 (10): 1817-18207. Xia Xing, Shen Ping, Yan Cuie. APS cultured bone marrow cells in long-term support hematopoiesis role of Traditional Chinese rudn Medicine Journal, 2003, 10 (4): 27-288. Zheng Xiaoxiang, Yang Yong, Ye Jianfeng, etc. donkey-hide gelatin in increasing the role and mechanism of white . Chinese Journal of Modern Applied Pharmacy, 2005, 22 (2): 103-105
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