加味八珍汤对急性髓系白血病化疗后毒副反应的防治作用  

Preventive and Therapeutic Effect of Modified Bazhen Decoction on Postchemotherapy Toxic and Side Reaction in Acute Myeloid Leukemia Patients

作　　者：朱玲玲[1,2] 朱晓光[1] 

机构地区：[1]南方医科大学附属中西医结合医院,广东广州510310 [2]南方医科大学南方医院中医科,广东广州510515

出　　处：《广州中医药大学学报》2014年第4期518-521,525,共5页Journal of Guangzhou University of Traditional Chinese Medicine

摘　　要：【目的】观察加味八珍汤对急性髓系白血病（acute myeloid leukemia,AML）化疗后毒副反应的防治作用。【方法】采用前瞻性、随机对照的方法,将70例AML患者随机分为治疗组和对照组各35例。对照组给予单纯标准化疗方案（HA、DA、IA）治疗,治疗组在标准化疗方案基础上给予加味八珍汤治疗。2组化疗均以7 d为1个疗程,共治疗2个疗程,2个疗程间隔21 d。治疗组在化疗及间隔期间均予以加味八珍汤治疗。2个疗程后,观察2组患者骨髓抑制程度、免疫功能情况以及治疗前后血常规、生活质量等变化情况。【结果】（1）在骨髓抑制方面,2周期化疗后,治疗组的骨髓抑制程度较对照组减轻,其中治疗组以玉~域度骨髓抑制为主,对照组以Ⅲ度以上骨髓抑制为主,2组比较差异有统计学意义（P〈0.01）。（2）在免疫力方面,2周期化疗后,2组的免疫球蛋白IgA、IgM、IgG和补体C3水平均显著降低,与治疗前比较差异有统计学意义（P〈0.05或P〈0.01）;但治疗组的免疫球蛋白IgA、IgG、IgM和补体C3水平的下降程度均较对照组轻,差异均有统计学意义（P〈0.05或P〈0.01）。（3）在血常规方面,2周期化疗后,2组的外周血白细胞（WBC）计数、血红蛋白（HGB）、血小板（PLT）水平均显著降低,与治疗前比较差异均有统计学意义（P〈0.05）;但治疗组的外周血WBC、HGB、PLT水平的下降程度均较对照组轻,差异均有统计学意义（P〈0.05）。（4）生活质量方面,与对照组比较,治疗组患者的生活质量改善程度明显提高,差异有统计学意义（P〈0.01）。【结论】加味八珍汤能有效减轻化疗后患者骨髓抑制情况,明显提高患者的免疫力,改善患者疲乏、食欲减退等临床症状,且服药期间未出现明显不良反应。Objective To observe the preventive and therapeutic effect of modified Bazhen Decoction （MBD） on post-chemotherapy toxic and side reaction in acute myeloid leukemia AML patients. Methods A prospective, randomized, and controlled trial was carried out in 70 cases of AML patients. The patients were evenly randomized into treatment group and control group. The control group was given standard chemotherapy regimen of HA, DA and IA alone, and the treatment group was given chemotherapy regimen combined with Chinese medicine MBD. Seven days constituted one chemotherapy treatment course, and the chemotherapy treatmentcoverde 2 treatment courses with an intermission of 21 days. Oral use of MBD was given during the two treatment courses and the interval period. At the end of the second treatment course, bone marrow depression and immune function were evaluated, and the blood routine indexes as well as the quality of life （QOL） were compared with those before treatment. Results （1） After 2 chemotherapy treatment courses, bone marrow depression of the treatment group was mainly at phase Ⅰ-Ⅱ , and that of the control group was mainly at phase Ⅲ or even more severer, the difference of the degree of bone marrow depression being significant （P〈0.01）. （2） As for the immune function, serum levels of immunoglobulin IgA, IgG, IgM and complement C3 were decreased in both groups after treatment （P〈0.05 or P〈0.01 compared with those before treatment）, and the fall was milder in the treatment group than that in the control group （P〈0.05 or P〈0.01）. （3） The peripheral white blood cell （WBC） count, hemoglobin （HGB） content and platelet （PLT） level were decreased in both groups after treatment （P〈0.05 compared with those before treatment）, and the fall was milder in the treatment group than that in the control group （P〈0.05）. （4） QOL was much improved in the treatment group after treatment （P〈 0.01 compared with that in the control group）. Conclusion MBD is e

关 键 词：急性髓系白血病 化学疗法 毒副作用 加味八珍汤 治疗应用 

分 类 号：R273.371[医药卫生—中西医结合]