目的：探讨填髓益精法联合环孢素A治疗再生障碍性贫血（AA）的临床疗效，及其对骨髓造血功能、免疫功能及生活质量的影响。方法：选取2021年1月—2026年1月收治的AA患者65例，随机分为对照组（21例）、中药组（23例）、综合组（21例）。对照组予环孢素A口服；中药组在对照组基础上加用填髓益精方口服；综合组在中药组基础上联合督灸、艾灸、耳针治疗。连续治疗24周，观察三组临床疗效、血常规、免疫指标、生活质量及不良反应。结果：对照组、中药组、综合组总有效率分别为76.19%、86.96%、85.71%，中药组与综合组均显著高于对照组（P<0.05）。治疗后，三组红细胞、血红蛋白、血小板均较治疗前升高（P<0.05），IL?2水平下降，CD3?、CD4?、CD4?/CD8?升高，中药组与综合组改善优于对照组（P<0.05）。生活质量评分综合组改善最优，三组不良反应发生率差异无统计学意义（P>0.05）。结论：填髓益精法联合环孢素A可有效提高AA临床疗效，改善骨髓造血与免疫功能，提升生活质量，安全性良好，值得临床推广。

Objective To investigate the clinical efficacy of traditional Chinese medicine (TCM) method of tonifying marrow and nourishing essence combined with cyclosporine A in the treatment of aplastic anemia (AA)， and its effects on bone marrow hematopoiesis， immune function and quality of life. Methods A total of 65 patients with AA admitted from July 2014 to January 2024 were randomly divided into control group (21 cases)， TCM group (23 cases) and comprehensive group (21 cases). The control group was treated with oral cyclosporine A; the TCM group was additionally given Tonifying Marrow and Nourishing Essence Decoction; the comprehensive group was further combined with governor vessel moxibustion， moxibustion and ear acupuncture on the basis of the TCM group. All patients were treated for 24 weeks. The clinical efficacy， blood routine， immune indexes， quality of life and adverse reactions were observed. Results The total effective rates of the control group， TCM group and comprehensive group were 76.19%， 86.96% and 85.71%， respectively. The TCM group and comprehensive group were significantly higher than the control group (P<0.05). After treatment， red blood cells， hemoglobin and platelets in the three groups were increased compared with those before treatment (P<0.05)， the levels of IL?2 were decreased， and CD3?， CD4? and CD4?/CD8? were increased. The improvements in the TCM group and comprehensive group were better than those in the control group (P<0.05). The quality of life score of the comprehensive group was the best， and there was no significant difference in the incidence of adverse reactions among the three groups (P>0.05). Conclusion TCM method of tonifying marrow and nourishing essence combined with cyclosporine A can effectively improve the clinical efficacy of AA， ameliorate bone marrow hematopoiesis and immune function， and improve quality of life with good safety， which is worthy of clinical promotion.

       目的   探讨淋巴细胞亚群在鉴别低增生性骨髓增生异常综合征（hypo-MDS）和再生障碍性贫血（AA）中的价值。方法   选取2020年7月—2023年6月在平顶山市第一人民医院治疗的80例hypo-MDS或和AA患者进行回顾性分析，其中hypo-MDS 48例、AA 32例，分析两组患者各类淋巴细胞（CD3⁺ 、CD4⁺ 、CD8⁺ 、CD4⁺ /CD8⁺ 、CD3⁺ CD57⁺ T-大颗粒淋巴细胞、CD3^- CD16/CD56⁺ 自然杀伤细胞、CD19⁺ B淋巴细胞）的差异。结果   hypo-MDS组的CD3⁺ （78.42±8.02）%与AA组的（75.65±8.44）%对比差异无统计学意义（P＞0.05）；hypo-MDS组的CD4⁺ （47.54±6.88）%、CD4⁺ /CD8⁺（2.16±0.61）%高于AA组的CD4⁺ （40.11±5.71）%、CD4⁺ /CD8⁺ （1.49±0.48）%，CD8⁺ （23.12±6.42）%低于AA组CD8⁺ （31.77±6.79）%（P＜0.05）；hypo-MDS患者CD3⁺ CD57⁺ T-大颗粒淋巴细胞（13.45±3.77）%、CD3^- CD16/CD56⁺自然杀伤细胞（12.32±3.97）%高于AA组CD3⁺ CD57⁺ T-大颗粒淋巴细胞（9.77±2.15）%、CD3^- CD16/CD56⁺ 自然杀伤细胞（8.84±2.11）%，CD19⁺ B淋巴细胞（9.75±2.08）%低于AA组（12.65±3.35）%（P＜0.05）。结论   淋巴亚群变化情况可用于AA和hypo-MDS的鉴别诊断。

       Objective  To explore the value of lymphocyte subsets in differentiation between hypoplastic myelodysplastic syndrome（hypo MDS）and aplastic anemia（AA）．Methods  A  retrospective analysis was conducted on 80 patients with hypo MDS and AA who underwent treatment in the First People’s Hospital of Pingdingshan City from July 2020 to June 2023．Among them，there were 48 cases of hypo MDS and 32 cases of AA．The differences in lymphocytes（CD3⁺ ，CD4⁺ ，CD8⁺ ，CD4⁺ /CD8⁺ ，CD3⁺ CD57⁺  T-large granular lymphocytes，CD3^- CD16/CD56⁺  natural killer cells，and CD19⁺  B lymphocytes）between the two groups of patients were analyzed．Results  There was no statistically significant difference in CD3⁺ （78.42±8.02）% between the hypo MDS group and the AA group（75.65±8.44）%（P＞0.05）．The CD4⁺ （47.54±6.88）% and CD4⁺ /CD8⁺ （2.16±0.61）% in the hypo MDS group were higher than those in the AA group（40.11±5.71）% and （1.49±0.48）%，respectively．The CD8⁺（23.12±6.42）% was lower than that in the AA group（31.77±6.79）%（P＜0.05）．The levels of CD3⁺ CD57⁺  T-large granular lymphocytes（13.45±3.77）% and CD3^- CD16/CD56⁺  natural killer cells（12.32±3.97）% in hypo MDS patients were higher than those in the AA group（［9.77±2.15］%，［8.84±2.11］%），and CD19⁺  B lymphoid cells（9.75±2.08）% were lower than that in the AA group（［12.65±3.35］%，P＜0.05）．Conclusions  The changes in lymphatic subpopulations can be used for the differential diagnosis of AA or hypo MDS．