当归四逆汤加减治疗白血病微小残留病的临床观察  

Use of modified Dangguisini Decoction for treatment of minimal residual disease in leukemic patients:a clinical study

作　　者：杨秀鹏[1] 麻柔[1] 许勇钢[1] 付中学[1] 唐旭东[1] 王德秀 朱千赜 Yang Xiupeng;Ma Rou;Xu Yonggang;Fu Zhongxue;Tang Xudong;Wang Dexiu;Zhu Qianze(Department of Hematology,Xiyuan Hospital,China Academy of Chinese Traditional Medical Sciences,Beijing 100091,China)

机构地区：[1]中国中医科学院西苑医院血液科,北京100091 [2]中国中医科学院研究生院

出　　处：《中国药物与临床》2021年第1期5-7,共3页Chinese Remedies & Clinics

基　　金：中国中医科学院“名医名家传承”项目(CM20141004)。

摘　　要：目的回顾性分析当归四逆汤加减治疗急性白血病(AL)患者微小残留病(MRD)的情况。方法以2013年1月至2019年1月就诊于中国中医科学院西苑医院血液科门诊的60例AL患者作为研究对象;采用病例系列研究的方法,根据患者提供的病历资料,AML患者MRD≥10-3为阳性,ALL患者MRD≥10-4为阳性;观察当归四逆汤治疗前、治疗6个月后AL患者MRD的情况和白细胞(WBC)计数、血红蛋白(Hb)计数、血小板(PLT)计数的变化。结果治疗前AL患者MRD阳性者31例,经当归四逆汤加减治疗6个月后MRD阳性转为阴性的有18例(58%);治疗前MRD阴性患者29例,经当归四逆汤加减治疗后6个月后仅有3例转为阳性。与治疗前相比,经当归四逆汤加减治疗的AL患者,WBC和Hb水平明显升高,差异有统计学意义(P<0.05);而PLT水平治疗前后无明显改变,差异无统计学意义(P>0.05)。结论当归四逆汤加减治疗AL患者,不仅可以维持MRD的阴性状态,而且还能使部分患者的MRD由阳性转为阴性。Objective To investigate the value of modified Dangguisini Decoction in the treatment of minimal residual disease(MRD)in patients with acute leukemia(AL).Methods Included in this study were 60 AL patients registered to the Clinic of Hematology,Xiyuan Hospital of China Academy of Chinese Traditional Medical Sciences between January 2013 and January 2019.According to the medical records in this case series,MRD positivity was considered when leukemic cells were greater than or equal to 10-3 for patients with acute myeloid leukemia(AML),or greater than or equal to 10-4 for patients with acute lymphoblastic leukemia(ALL).Before and at 6 months after treatment with modified Dangguisini Decoction,the MRD,white blood cell(WBC)counts,hemoglobin(Hb),and platelet(PLT)were examined in all AL patients.Results There were 31 MRD-positive AL patients before treatment,18 of whom(58%)turned MRD-negative after 6 months of treatment with Dangguisini Decoction.There were 29 MRD-negative AL patients before treatment;only 3 became MRD-positive after 6 months of treatment with Dangguisini Decoction.Compared with before treatment,WBC and Hb levels were significantly higher in patients after treatment with modified Dangguisini Decoction,with statistically significant differences(P<0.05).There was no significant change in PLT level before and after treatment(P>0.05).Conclusion Treatment of AL with modified Dangguisini Decoction may help maintain MRD negativity,and also lead to negative conversion in part of MRD-positive patients.

关 键 词：当归四逆汤 白血病 微小残留病 

分 类 号：R273[医药卫生—中西医结合]