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1.广州中医药大学第一附属医院,广东省广州市白云区机场路16号,510405
2.广东省中医临床研究院
3.广州中医药大学
4.中山大学孙逸仙纪念医院儿童医学中心
Received:23 October 2025,
Revised:2025-12-30,
Published:17 March 2026
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黄宝仪,易立琛,李燕维等.中医药疗法对造血干细胞移植后患儿免疫重建的影响——回顾性真实世界研究[J].中医杂志,2026,67(06):630-638.
HUANG Baoyi,YI Lichen,LI Yanwei,et al.Effect of Traditional Chinese Medicine Therapy on Immune Reconstitution in Children after Hematopoietic Stem Cell Transplantation:A Retrospective Real-World Study[J].Journal of Traditional Chinese Medicine,2026,67(06):630-638.
黄宝仪,易立琛,李燕维等.中医药疗法对造血干细胞移植后患儿免疫重建的影响——回顾性真实世界研究[J].中医杂志,2026,67(06):630-638. DOI: 10.13288/j.11-2166/r.2026.06.008.
HUANG Baoyi,YI Lichen,LI Yanwei,et al.Effect of Traditional Chinese Medicine Therapy on Immune Reconstitution in Children after Hematopoietic Stem Cell Transplantation:A Retrospective Real-World Study[J].Journal of Traditional Chinese Medicine,2026,67(06):630-638. DOI: 10.13288/j.11-2166/r.2026.06.008.
目的
2
基于真实世界观察中医药疗法对造血干细胞移植(HSCT)后患儿免疫重建的影响。
方法
2
通过回顾性队列研究纳入HSCT后患儿。观察组为HSCT后曾经接受连续12周中医辨证治疗者,对照组为HSCT后未接受中医药治疗者。应用倾向性评分卡钳匹配法控制混杂因素。通过多重线性回归探讨两组在观察组接受中药干预前后分别对应时点的免疫指标[包括淋巴细胞亚群(CD3
+
T细胞、CD3
+
CD4
+
T细胞、CD3
+
CD8
+
T细胞、CD3
-
CD19
+
B细胞、CD3
-
(CD16+CD56)
+
NK细胞、CD3
+
CD56
+
细胞的绝对值及以上细胞占淋巴细胞的比值、CD4
+
/CD8
+
比值、CD3
+
CD4
+
CD25
+
CD127
-
T细胞(Treg细胞)占CD3
+
CD4
+
T细胞的比值(Treg/CD4
+
)]、免疫球蛋白(IgA、IgG、IgM、IgE)及补体C3、C4水平的差异,并比较组内治疗前后免疫指标的变化;记录患儿随访时间并评估两组患儿HSCT后的总生存期。
结果
2
共纳入观察组31例,对照组56例,经倾向性评分匹配控制混杂因素后两组纳入各28例。治疗前观察组患儿Treg/CD4
+
T细胞比值高于对照组(
<math id="M1"><mi>P</mi></math>
https://html.publish.founderss.cn/rc-pub/api/common/picture?pictureId=101987996&type=
https://html.publish.founderss.cn/rc-pub/api/common/picture?pictureId=101987991&type=
2.28600001
2.62466669
<0.05),其余免疫指标差异无统计学意义(
<math id="M2"><mi>P</mi></math>
https://html.publish.founderss.cn/rc-pub/api/common/picture?pictureId=101988044&type=
https://html.publish.founderss.cn/rc-pub/api/common/picture?pictureId=101988030&type=
2.28600001
2.62466669
>0.05)。治疗后通过多重线性回归进行两组间比较,观察组CD3
+
T细胞比值高于对照组(
<math id="M3"><mi>P</mi></math>
https://html.publish.founderss.cn/rc-pub/api/common/picture?pictureId=101988044&type=
https://html.publish.founderss.cn/rc-pub/api/common/picture?pictureId=101988030&type=
2.28600001
2.62466669
<0.05)。组内自身治疗前后比较,观察组治疗后CD3
+
CD4
+
T细胞绝对值及
其比值、IgE均较治疗前升高(
<math id="M4"><mi>P</mi></math>
https://html.publish.founderss.cn/rc-pub/api/common/picture?pictureId=101988044&type=
https://html.publish.founderss.cn/rc-pub/api/common/picture?pictureId=101988030&type=
2.28600001
2.62466669
<0.01);对照组治疗后CD3
+
CD4
+
T细胞绝对值及其比值、CD4
+
/CD8
+
比值、Treg/CD4
+
T细胞比值、IgE较治疗前升高(
<math id="M5"><mi>P</mi></math>
https://html.publish.founderss.cn/rc-pub/api/common/picture?pictureId=101988044&type=
https://html.publish.founderss.cn/rc-pub/api/common/picture?pictureId=101988030&type=
2.28600001
2.62466669
<0.05或
<math id="M6"><mi>P</mi></math>
https://html.publish.founderss.cn/rc-pub/api/common/picture?pictureId=101988044&type=
https://html.publish.founderss.cn/rc-pub/api/common/picture?pictureId=101988030&type=
2.28600001
2.62466669
<0.01);对照组治疗后CD3
+
CD8
+
T细胞绝对值及其比值、CD3
+
CD56
+
细胞比值较治疗前下降(
<math id="M7"><mi>P</mi></math>
https://html.publish.founderss.cn/rc-pub/api/common/picture?pictureId=101988044&type=
https://html.publish.founderss.cn/rc-pub/api/common/picture?pictureId=101988030&type=
2.28600001
2.62466669
<0.05或
<math id="M8"><mi>P</mi></math>
https://html.publish.founderss.cn/rc-pub/api/common/picture?pictureId=101988044&type=
https://html.publish.founderss.cn/rc-pub/api/common/picture?pictureId=101988030&type=
2.28600001
2.62466669
<0.01)。两组平均随访(29.55±12.71)个月,观察组生存率96.43%,对照组生存率89.29%,两组患儿总生存期比较差异无统计学意义(
<math id="M9"><mi>P</mi></math>
https://html.publish.founderss.cn/rc-pub/api/common/picture?pictureId=101988044&type=
https://html.publish.founderss.cn/rc-pub/api/common/picture?pictureId=101988030&type=
2.28600001
2.62466669
>0.05)。
结论
2
中医药疗法可整体改善HSCT后患儿的免疫功能,尤其明显提高CD3
+
CD4
+
T细胞的绝对值和比值。
Objective
2
To explore the effect of traditional Chinese medicine (TCM) therapy on the immune reconstitution of children after hematopoietic stem cell transplantation (HSCT) based on real-world study.
Methods
2
This retrospective cohort study included children who had undergone HSCT. The observation group consisted of children who had received 12 consecutive weeks of TCM treatment after HSCT, while the control group included children who didn't receive TCM treatment after HSCT. Propensity sc
ore matching was used to control for confounding factors. Multiple linear regression was used to explore the differences in immune indicators between groups at corresponding time points before and after the observation group received TCM treatment. These immune indicators included lymphocyte subsets such as CD3
+
T cells, CD3
+
CD4
+
T cells, CD3
+
CD8
+
T cells, CD3
-
CD19
+
B cells, CD3
-
(CD16+CD56)
+
NK cells, and CD3
+
CD56
+
cells, along with their absolute values and ratios to total lymphocytes. Additionally, the CD4
+
/CD8
+
ratio and the ratio of CD3
+
CD4
+
CD25
+
CD127
-
T cells (Treg cells) to CD3
+
CD4
+
T cells (Treg/CD4
+
) were assessed. Immunoglobulins (IgA, IgG, IgM, IgE) and complement C3, C4 were also analyzed for differences. The changes in immune indicators before and after treatment within group were compared. The follow-up time was recorded, and the overall survival (OS) of children after HSCT was also evaluated.
Results
2
The retrospective cohort study included 31 children in the observation group and 56 in the control group. After propensity score matching to control for confounding factors, 28 children were included in each group. Before treatment, the Treg/CD4
+
T cell ratio in the observation group was higher than that in the control group (
P
<0.05), while other immune indicators showed no significant differences (
P
>0.05). After treatment, multiple linear regression comparison showed that the CD3
+
T cell ratio in the observation group was significantly higher than that in the control group (
P
<0.05). Within-group comparisons showed that in the observation group, the absolute values of CD3
+
CD4
+
T cells and their ratios, as well as IgE, increas
ed significantly after treatment (
P
<0.01). In the control group, the absolute values of CD3
+
CD4
+
T cells and their ratios, the CD4
+
/CD8
+
ratio, the Treg/CD4
+
T cell ratio and IgE increased significantly after treatment (
P
<0.05 or
P
<0.01). The absolute values of CD3
+
CD8
+
T cells and their ratios, as well as the CD3
+
CD56
+
cell ratio, decreased significantly after treatment (
P
<0.05 or
P
<0.01). The average follow-up period of both groups was 29.55±12.71 months, with a survival rate of 96.43% in the observation group and 89.29% in the control group. There was no statistically significant difference in OS between groups (
P
>0.05).
Conclusion
2
TCM therapy can significantly improve the immune function of children after HSCT, particularly by increasing the absolute value and ratio of CD3
+
CD4
+
T cells.
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