中西医个体化分层治疗老年急性髓系白血病回顾性分析  

Retrospective Analysis on the Individualized Stratified Treatment of Senile Acute Myeloid Leukemia by Integrated Traditional Chinese and Western Medicine

作　　者：史哲新[1] 王秀婷 闫理想 高宏[1] 姚芳[1] 王兴丽[1] 

机构地区：[1]天津中医药大学第一附属医院血液科,天津300381 [2]天津中医药大学研究生院,天津300193

出　　处：《中国中西医结合杂志》2017年第9期1069-1072,共4页Chinese Journal of Integrated Traditional and Western Medicine

基　　金：天津市应用基础及前沿技术研究计划重点资助项目(No.12JCZDJC25400)

摘　　要：目的回顾性分析中西医个体化分层治疗老年急性髓系白血病(AML)的临床疗效和不良反应。方法采用回顾性研究方法,根据患者合并的基础疾病、体力状态(ECOG)评分、治疗方法将54例老年AML患者分为A组(扶正祛邪方加减+标准剂量化疗组,19例)、B组(扶正祛邪方加减+减低剂量化疗组,18例)、C组(扶正祛邪方加减姑息治疗组,17例),分析患者骨髓缓解率、生存时间、中医证候疗效和不良反应。结果54例患者缓解率为68.5%(37/54),平均生存时间为(12.9±6.0)个月,中位生存时间为13个月,1年及以上生存率为55.6%(30/54),中医证候总有效率为83.3%(45/54),患者出现感染、胃肠道反应、心脏毒性、肝肾毒性的发生率分别为25.9%(14/54)、16.7%(9/54)、11.1%(6/54)、7.4%(4/54)。除中医证候疗效外,C组其余指标均低于A、B组(P<0.05)。结论中西医个体化分层方案可提高老年AML临床疗效,减少不良反应的发生,提高生存质量,增加远期疗效。Objective To retrospectively analyse clinical effect and adverse reaction in treating senile acute myeloid leukemia（ AML） with individualized stratified treatment of integrated Chinese and Western medicine.Methods According to the patients＇ basic disease,ECOG score,treatment method,54 cases of AML patients were assigned to group A [Modified Fuzheng Quxie Recipe（ MFQR） ＋ standard dose chemotherapy group,19 cases],group B（ MFQR ＋ low dosage chemotherapy group,18 cases）,group C（ MFQR palliative treatment group,17cases）. The bone marrow remission rate,survival time,total effective rate of Chinese Medicine（ CM） syndrome and adverse reaction were analyzed retrospectively. Results The remission rate was 68. 5%（ 37/54）,average survival time was 12. 9 ± 6. 0 months,median survival time was 13 months,and 1-year and above survival was 55. 6%（ 30/54）. The total effective rate of CM syndrome was 83. 3%（ 45/54）. The incidence of infection,gastrointestinal reaction,cardiotoxicity,liver and kidney toxicity were 25. 9%（ 14/54）,16. 7%（ 9/54）,11. 1%（ 6/54） and7. 4%（ 4/54）. In addition to the efficacy of CM syndrome,the remaining indicators of group C were lower than those in group A and B（P 0. 05）. Conclusion Individualized stratified treatment of integrated Chinese and Western medicine can improve the clinical efficacy on senile AML,reduce the incidence of adverse reactions,improve the quality of life,increase the long-term efficacy.

关 键 词：老年急性髓系白血病 中西医结合 个体化分层治疗 回顾性分析 

分 类 号：R733.71[医药卫生—肿瘤]