八珍汤联合地西他滨、CAG化疗方案治疗老年急性髓系白血病的临床研究  

Clinical study of Bazhen Decoction combined with decitabine and CAG chemotherapy in the treatment of elderly acute myeloid leukemia

作　　者：张小亮[1,2] 曲慧[3] 江涛[2] 王萍 刘宝文[2] ZHANG Xiaoliang;QU Hui;JIANG Tao;WANG Ping;LIU Baowen(School of the First Clinical Medical Sciences,Liaoning University of Traditional Chinese Medicine,Shenyang,Liaoning 110847,China;Department of Hematology,Affiliated Hospital of Liaoning University of Traditional Chinese Medicine,Shenyang,Liaoning 110032,China;Department of Geriatric Respiratory Medicine,The First Affiliated Hospital of China Medical University,Shenyang,Liaoning 110001,China)

机构地区：[1]辽宁中医药大学第一临床学院,辽宁沈阳110847 [2]辽宁中医药大学附属医院血液科,辽宁沈阳110032 [3]中国医科大学附属第一医院老年呼吸科,辽宁沈阳110001

出　　处：《上海中医药杂志》2021年第4期55-59,共5页Shanghai Journal of Traditional Chinese Medicine

基　　金：国家自然科学基金项目(81774258)。

摘　　要：目的观察八珍汤联合地西他滨、CAG方案对老年急性髓系白血病(AML)的临床疗效。方法将64例老年AML患者随机分为对照组和治疗组,每组32例。对照组采用地西他滨、CAG方案化疗,治疗组在对照组治疗措施基础上加服八珍汤;两组均以28 d为1个疗程,共治疗2个疗程。观察临床疗效、化疗后重度骨髓抑制及不良反应的发生情况,比较中医证候积分的变化情况。结果 (1)西医疾病疗效:治疗组总有效率为50.00%,对照组总有效率为46.88%;组间西医疾病疗效比较,差异无统计学意义(P>0.05)。中医证候疗效:治疗组总有效率62.50%,对照组总有效率46.88%;组间中医证候疗效比较,差异有统计学意义(P<0.05)。(2)治疗前后组内比较,治疗组骨痛、瘀斑、头晕、乏力、纳差、发热积分降低(P<0.05),对照组仅骨痛、头晕、乏力、纳差积分降低(P<0.05);组间治疗后比较,治疗组瘀斑、头晕、乏力、纳差、发热积分低于对照组(P<0.05)。(3)治疗组重度骨髓抑制(Ⅲ级)及心力衰竭、肺部感染、胃肠道不适发生率均低于对照组(P<0.05)。结论八珍汤联合地西他滨、CAG方案治疗老年AML疗效满意,有助于改善化疗后患者的骨髓抑制程度及气血亏虚症状,并减少化疗不良反应的发生。Objective To observe the clinical effect of Bazhen Decoction combined with decitabine and CAG chemotherapy in the treatment of elderly acute myeloid leukemia(AML). Methods Totally 64 elderly AML were randomly divided into control group(n=32) and treatment group(n=32). The control group was administered with decitabine and CAG chemotherapy, while the treatment group was additionally administered with Bazhen Decoction besides the treatment of the control group. Both groups were treated for 2 courses of treatment, and each course lasted 28 days. The clinical effect, the incidence of severe myelosuppression and adverse reactions after chemotherapy were observed, and the changes of TCM syndrome scores were compared. Results(1)The curative effect of AML: the total effective rate of the treatment group was 50.00%, and that of the control group was 46.88%. There was no significant difference in the curative effect of AML between groups(P>0.05). The curative effect of TCM syndromes: the total effective rate of the treatment group was 62.50%, and that of the control group was 46.88%. The difference of TCM syndrome curative effect between groups was statistically significant(P<0.05).(2)According to the intra-group comparison before and after treatment, the scores of bone pain, ecchymosis,dizziness,fatigue, anorexia and fever in the treatment group decreased( P<0.05), while only the scores of bone pain,dizziness,fatigue and anorexia in the control group decreased( P<0.05);After treatment,the scores of ecchymosis,dizziness,fatigue,anorexia and fever in the treatment group were lower than those in the control group( P<0.05).(3)The incidences of severe myelosuppression( grade Ⅲ),heart failure,pulmonary infection and gastrointestinal discomfort in the treatment group were lower than those in the control group( P<0.05). Conclusion Bazhen Decoction combined with decitabine and CAG chemotherapy regimen is effective in treating elderly AML as Bazhen Decoction is helpful to improve the myelosuppression and the symptoms of deficienc

关 键 词：急性髓系白血病 老年人 八珍汤 地西他滨 CAG方案 化疗 骨髓抑制 

分 类 号：R733.71[医药卫生—肿瘤]