两种治则在防治化疗骨髓抑制中的差异分析及合理应用  

Analysis and Reasonable Application of Two Therapeutic Principles in the Treatment of Myelosuppression

作　　者：张学伟[1] 耿平[1] 张继鹏[1] 王征[1] 梁婷[1] 

机构地区：[1]泰安市肿瘤防治院,山东泰安271000

出　　处：《中医药学报》2016年第2期70-73,共4页Acta Chinese Medicine and Pharmacology

基　　金：山东省中医药科技支撑计划(2013-319)

摘　　要：目的:探讨健脾养血和补肾益精两种治则组方在防治化疗骨髓抑制临床应用中的差异及合理应用。方法:160例肿瘤患者随机分为4组,根据患者病情给予规律化疗,空白组、补肾益精组、益气养血组及健脾补肾组在化疗同期分别口服不同中药方剂;各组患者在化疗第1天及第7天检查血细胞分析并记录患者白细胞、血红蛋白及血小板变化情况;各组患者在第1周期化疗第1天及第2周期化疗第7天检测血清G-CSF、EPO、TPO及IL-3水平并记录。结果:补肾益精组在维持白细胞计数水平方面效果最强,健脾补肾组在维持血红蛋白及血小板计数水平方面效果最强,益气养血组对三系血细胞的作用介于两组之间;补肾益精组在刺激G-CSF及IL-3分泌方面效果最强,益气养血组在刺激EPO及TPO分泌方面效果最强。结论:不同治疗原则、不同药物配比组方均可以减轻化疗骨髓抑制程度,恢复骨髓造血功能,但对三系血细胞的作用效果不同,对不同造血调控因子的促进分泌效果不同,不同造血刺激因子之间存在协同作用,共同促进骨髓造血,临床在组方用药过程中,应根据患者的不同情况、骨髓抑制程度及血常规情况选择合适的组方原则,调整药物配比。Objective： To discuss the difference and reasonable application of two therapeutic principles in the treatment of myelosuppression. Methods： 160 tumor patients were randomly divided into four groups,giving different oral Chinese medicine prescriptions during the same period of regular chemotherapy; check blood cell analysis on the 1st and 7th day of chemotherapy to record patients＇ white blood cells,hemoglobin and platelet changes; check serum levels of G-CSF,EPO,TPO and IL-3 on the 1st day of the 1st chemotherapy cycle and the 7th day of the 2nd chemotherapy cycle. Results： The effect of Bushen Yijing group was the best in maintaining white blood cell count; the effect of Jianpi Bushen group was the best in maintaining hemoglobin and platelet count; the effect of Yiqi Yangxue group in maintaining the three blood cells was between the two groups; the effect of Bushen Yijing group in the stimulation of G-CSF and IL-3was the best; the effect of Yiqi Yangxue group in the stimulation of EPO and TPO was the best. Conclusion： Both of the therapeutic principles and ratio of drug formula can reduce chemotherapy myelosuppression,restore hematopoietic function of marrow,but the effects on three blood cells are different,and the effect on stimulating hematopoiesis regulation factors is different; different hematopoietic regulation factors have synergies,jointly promoting hematopoiesis; the reagent dosage should be according to different situations of patients,myelosuppression-degrees and routine blood situation to choose the appropriate formula principle,adjusting the ratio of drug.

关 键 词：白细胞减少 骨髓抑制 放化疗毒副反应 中药疗法 

分 类 号：R273[医药卫生—中西医结合]