目的 探讨复方皂矾丸联合环孢素A和沙利度胺治疗低危骨髓增生异常综合征的临床疗效。方法 选取2014年5月-2016年5月东台市人民医院收治的低危骨髓增生异常综合征患者130例，按照治疗方法的差别分成对照组（65例）和治疗组（65例）。对照组口服环孢素软胶囊，初始剂量为5 mg/（kg·d），维持剂量为10 mg/（kg·d）；同时口服沙利度胺胶囊，初始剂量为50 mg/d，1周后为100 mg/d并服用1周，若无不良反应递增至200 mg/d并维持。治疗组在对照组的基础上口服复方皂矾丸，9丸/次，3次/d。两组患者均连续治疗12周。观察两组患者的临床疗效，检测并比较两组患者治疗前后的白细胞介素-10（IL-10）、肿瘤坏死因子-α（TNF-α）、干扰素-γ（IFN-γ）、血管内皮生长因子（VEGF）、血红蛋白（Hb）和血小板（PLT）以及CD3⁺CD4⁺、CD3⁺CD8⁺和CD4⁺CD25⁺水平。结果 治疗后，对照组和治疗组总有效率分别为61.54%和81.54%，两组比较差异具有统计学意义（P<0.05）。治疗后，两组患者血清TNF-α、IFN-γ和VEGF水平均明显降低，IL-10水平升高，同组治疗前后差异具有统计学意义（P<0.05）。与对照组相比，治疗后治疗组上述指标改善更显著，差异具有统计学意义（P<0.05）。治疗后，两组患者Hb、PLT水平均明显升高，同组治疗前后差异具有统计学意义（P<0.05）。且治疗组比对照组升高更明显，两组比较差异具有统计学意义（P<0.05）。治疗后，两组患者CD3⁺CD4⁺和CD3⁺CD8⁺水平均明显降低，CD4⁺CD25⁺水平明显升高，同组治疗前后差异具有统计学意义（P<0.05）。且治疗后治疗组上述指标比对照组的改善更显著，差异具有统计学意义（P<0.05）。结论 复方皂矾丸联合环孢素A和沙利度胺治疗低危骨髓增生异常综合征的效果显著，可有效改善机体免疫机能，具有一定的临床推广应用价值。

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.