目的 探討復(fù)方皂礬丸聯(lián)合環(huán)孢素A和沙利度胺治療低危骨髓增生異常綜合征的臨床療效。方法 選取2014年5月-2016年5月東臺(tái)市人民醫(yī)院收治的低危骨髓增生異常綜合征患者130例，按照治療方法的差別分成對(duì)照組（65例）和治療組（65例）。對(duì)照組口服環(huán)孢素軟膠囊，初始劑量為5 mg/（kg·d），維持劑量為10 mg/（kg·d）；同時(shí)口服沙利度胺膠囊，初始劑量為50 mg/d，1周后為100 mg/d并服用1周，若無(wú)不良反應(yīng)遞增至200 mg/d并維持。治療組在對(duì)照組的基礎(chǔ)上口服復(fù)方皂礬丸，9丸/次，3次/d。兩組患者均連續(xù)治療12周。觀察兩組患者的臨床療效，檢測(cè)并比較兩組患者治療前后的白細(xì)胞介素-10（IL-10）、腫瘤壞死因子-α（TNF-α）、干擾素-γ（IFN-γ）、血管內(nèi)皮生長(zhǎng)因子（VEGF）、血紅蛋白（Hb）和血小板（PLT）以及CD3⁺CD4⁺、CD3⁺CD8⁺和CD4⁺CD25⁺水平。結(jié)果 治療后，對(duì)照組和治療組總有效率分別為61.54%和81.54%，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組患者血清TNF-α、IFN-γ和VEGF水平均明顯降低，IL-10水平升高，同組治療前后差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。與對(duì)照組相比，治療后治療組上述指標(biāo)改善更顯著，差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組患者Hb、PLT水平均明顯升高，同組治療前后差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。且治療組比對(duì)照組升高更明顯，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組患者CD3⁺CD4⁺和CD3⁺CD8⁺水平均明顯降低，CD4⁺CD25⁺水平明顯升高，同組治療前后差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。且治療后治療組上述指標(biāo)比對(duì)照組的改善更顯著，差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。結(jié)論 復(fù)方皂礬丸聯(lián)合環(huán)孢素A和沙利度胺治療低危骨髓增生異常綜合征的效果顯著，可有效改善機(jī)體免疫機(jī)能，具有一定的臨床推廣應(yīng)用價(jià)值。

Objective To evaluate the clinical efficacy of Compound Zaofan Pills combined with cyclosporine A and thalidomide in treatment of low-risk myelodysplastic syndromes. Methods Patients (130 cases) with low-risk myelodysplastic syndromes in Dongtai People's Hospital from May 2014 to May 2016 were divided into the control (65 cases) and treatment (65 cases) groups based on different treatment. The patients in the control group were po administered with Ciclosporin Soft Capsules, the initial dosage was 5 mg/(kg·d), and the maintenance dosage was 10 mg/(kg·d). And they were po administered with Thalidomide Capsules, the initial dosage was 50 mg/d, which was increased to 100 mg/d after one week, then maintained for 1 week, if there was no adverse reactions, the dosage was increased to 200 mg/d and maintained. The patients in the treatment group were po administered with Compound Zaofan Pills on the basis of the control group, 9 pills/time, three times daily. The patients in two groups were treated for 12 weeks. After treatment, the clinical efficacy of the two groups was observed, and TNF-α, IFN-γ, VEGF, Hb, PLT, CD3⁺CD4⁺, CD3⁺CD8⁺, and CD4⁺CD25⁺ levels in two groups were detected and compared. Results After treatment, the clinical efficacy in the control and treatment group were 61.54% and 81.54%, respectively, and there were differences between two groups (P<0.05). After treatment, TNF-α, IFN-γ, and VEGF levels in two groups were significantly decreased, but IL-10 was increased, and the difference was statistically significant in the same group (P<0.05). Compared with the control group, these indicators in treatment group were more significantly improved than those in the control group, with significant difference between two groups (P<0.05). After treatment, Hb and PLT levels in two groups were significantly increased, and the difference was statistically significant in the same group (P<0.05). And Hb and PLT levels in the treatment group were more significantly increased than those in the control group, with significant difference between two groups (P<0.05). After treatment, CD3⁺CD4 and CD3⁺CD8⁺ levels in two groups were significantly decreased, but CD4⁺CD25⁺ levels were significantly increased, and the difference was statistically significant in the same group (P<0.05). And these indicators in the treatment group were significantly better than those in the control group, with significant difference between two groups (P<0.05). Conclusion Compound Zaofan Pills combined with cyclosporine A and thalidomide has a significant effect in treatment of low-risk myelodysplastic syndromes, can effectively improve the immune function, which has a certain clinical application value.