补阳还五汤对亚砷酸治疗急性早幼粒细胞白血病患者的心脏保护作用  

Cardioprotective Effect of Buyang Huanwu Decoction on Acute Promyelocytic Leukemia Patients Treated with Arsenious Acid

作　　者：李明[1] 王树庆[2] 王晓宝[2] LI Ming;WANG Shu-Qing;WANG Xiao-Bao(Weifang Medical University,Weifang 261042 Shandong,China;Affiliated Hospital of Weifang Medical University,Weifang 261031 Shandong,China)

机构地区：[1]潍坊医学院,山东潍坊261042 [2]潍坊医学院附属医院,山东潍坊261031

出　　处：《广州中医药大学学报》2021年第7期1325-1329,共5页Journal of Guangzhou University of Traditional Chinese Medicine

基　　金：山东省中医药科技发展计划项目(编号:2019-0437)。

摘　　要：【目的】评价补阳还五汤对亚砷酸治疗的急性早幼粒细胞白血病(APL)患者心脏的保护作用。【方法】将62例使用亚砷酸化疗而引起心脏毒性患者随机分为治疗组和对照组,每组各31例。对照组给予西医常规治疗(包括将维生素C 3.0 g加入5%葡萄糖注射液100 m L中静脉滴注,1次/d,同时口服辅酶Q10 10 mg,3次/d),治疗组在西医常规治疗的基础上给予补阳还五汤中药配方颗粒治疗。7 d为1个疗程,共治疗2个疗程。观察2组患者化疗后所致心肌损害的改善疗效、心电图异常改变的治愈率和心肌肌钙蛋白Ⅰ变化值情况。【结果】(1)在改善化疗后所致心肌损害方面,治疗组的显效率和总有效率分别为83.9%(26/31)和100.0%(31/31),对照组分别为54.8%(17/31)和96.8%(30/31);2组总有效率比较,差异无统计学意义(P>0.05),但治疗组的显效率明显优于对照组,差异有统计学意义(P<0.05),表明治疗组对化疗后所致心肌损害的改善疗效优于对照组。(2)在心电图异常改变的治愈率方面,治疗组的治愈率为100.0%(11/11),对照组为83.3%(10/12),组间比较,差异无统计学意义(P>0.05)。(3)在心肌肌钙蛋白Ⅰ变化值方面,治疗组与对照组治疗前后肌钙蛋白Ⅰ变化值分别为(0.211±0.109)μg/L和(0.157±0.098)μg/L,组间比较,治疗组患者的肌钙蛋白Ⅰ变化值明显高于对照组,差异有统计学意义(P<0.05)。【结论】应用亚砷酸治疗APL患者所致的心肌损伤是可逆的,补阳还五汤对其具有较好的治疗作用。Objective To evaluate the protective effect of Buyang Huanwu Decoction on the heart of acute promyelocytic leukemia(APL) patients treated with arsenious acid. Methods A randomized, controlled,multicenter clinical study was conducted in 62 APL patients with cardiac toxicity caused by the treatment with arsenious acid. The enrolled patients were randomly divided into treatment group and control group, and each group had 31 cases. The control group received intravenous drip of the solution of vitamin C 3.0 g with 100 mL of 5%glucose injection added once a day,and was given oral use of coenzyme Q10 10 mg,three times a day. In addition to the above treatment for the control group,the treatment group was also given oral use of the granules of Buyang Huanwu Decoction. Seven days constituted a course of treatment,and the two groups were treated for two courses.The efficacy for the improvement of myocardial damage caused by the chemotherapy,the cure rate for abnormal electrocardiogram(ECG)and the improvement of cardiac troponin Ⅰ value were compared between the two groups.Results(1)For the improvement of myocardial damage caused by the chemotherapy,the markedly effective rate and the total effective rate in the treatment group were 83.9%(26/31)and 100.0%(31/31)respectively,and those in the control group were 54.8%(17/31)and 96.8%(30/31)respectively. The intergroup comparison showed that the difference of total effective rate between the two groups was insignificant(P>0.05),but the markedly effective rate in the treatment group was superior to that in the control group, and the difference was statistically significant(P<0.05), indicating that the treatment group had stronger effect on improving the myocardial damage than the control group.(2)After treatment,the cure rate for abnormal ECG in the treatment group was100.0%(11/11)and that in the control group was 83.3%(10/12). The intergroup comparison showed that the difference of the cure rate between the two groups was insignificant(P>0.05).(3)For the improvement of cardi

关 键 词：补阳还五汤 亚砷酸 急性早幼粒细胞白血病(APL) 心脏毒性 心肌肌钙蛋白I 

分 类 号：R273.337[医药卫生—中西医结合]