加味生脉饮辅助化疗对气血两虚证急性淋巴细胞白血病患儿的影响  

Effect of Modified Shengmaiyin on Children with Acute Lymphocyte Leukemia of Deficiency of Both Qi and Blood

作　　者：安娜[1] 张古英[1] 赵宜乐 曹利红[2] 王婧[3] 张雪 梁玉丽[1] AN Na;ZHANG Gu-ying;ZHAO Yi-le;CAO Li-hong;WANG Jing;ZHANG Xue;LIANG Yu-li(Hebei Children's Hospital,Shijiazhuang 050031,China;Hebei Hospital of Traditional Chinese Medicine,Shijiazhuang 050013,China;The First Hospital of Hebei Medical University,Shijiazhuang 050030,China;Affiliated Hospital of Hebei Engineering University,Handan 056002,China)

机构地区：[1]河北省儿童医院,石家庄050031 [2]河北省中医院,石家庄050013 [3]河北医科大学第一医院,石家庄050030 [4]河北工程大学附属医院,河北邯郸056002

出　　处：《中国实验方剂学杂志》2021年第19期126-131,共6页Chinese Journal of Experimental Traditional Medical Formulae

基　　金：河北省2018年度医学科学研究重点课题(20180627)。

摘　　要：目的:观察加味生脉饮辅助化疗对气血两虚证急性淋巴细胞白血病(ALL)患儿营养情况和免疫功能的调节效果。方法:将100例ALL化疗患儿按随机数字表法分为观察组和对照组各50例。两组患儿均给予长春新碱(泼尼松)+柔红霉素+左旋门冬酰胺酶(VDLD)方案进行诱导缓解治疗和环磷酰胺+阿糖胞苷+6-巯基嘌呤(CAM)方案进行早期强化治疗。对照组口服生脉饮,10 m L/次,3次/d。观察组口服加味生脉饮,1剂/d。两组疗程均为3个月。进行治疗前后微型营养评定(MNA),并检测治疗前后血清总蛋白(TB),白蛋白(ALB),前白蛋白(PAB),T细胞CD4^(+),CD8^(+),免疫球蛋白G(IgG),免疫球蛋白M(IgM),免疫球蛋白A(IgA)水平,计算CD4^(+)/CD8^(+);进行治疗前后中医证候评分,Piper疲乏修订量表(PFS-R)和儿童生活质量普适性核心量表(Peds QL)评分;评价治疗前后白细胞(WBC),红细胞(RBC),血红蛋白(Hb)和血小板(PLT)变化。结果:治疗后观察组营养状况高于对照组(Z=2.018,P<0.05);观察组疲乏程度低于对照组(Z=2.029,P<0.05);观察组MNA评分高于对照组(P<0.01),PFS-R和气血两虚证评分均低于对照组(P<0.01);观察组TB,ALB,PAB,CD4^(+)水平和CD4^(+)/CD8^(+)均高于对照组(P<0.01),CD8^(+)低于对照组(P<0.01);观察组Ig M和Ig A水平均高于对照组(P<0.01);观察组RBC,Hb和PLT水平均高于对照组(P<0.01)。结论:加味生脉饮内服辅助用于ALL化疗患儿,可提高营养状况,改善免疫功能,促进免疫平衡,减轻临床症状,促进造血系统的恢复,提高生活质量。Objective:To observe the regulatory effect of modified Shengmaiyin adjuvant chemotherapy on the nutritional status and immune function of children with acute lymphocyte (ALL).Method:One hundred children with ALL chemotherapy were randomly divided into observation group and control group.Both groups were given VDLD regimen as the induction therapy and CAM regimen as the early therapy.Control group was given Shengmaiyin orally,10 m L/time,3 times/day.Observation group was givenmodified Shengmaiyin orally,1 does/day.The course of treatment for both groups was 3 months.Micro-nutrition assessment(MNA)was carried out before and after treatment,and serum total protein(TB),albumin(ALB),prealbumin(PAB),T cell CD4^(+),CD8^(+),immunoglobulin G(Ig G),Ig M,Ig A levels were detected before and after treatment.The ratio of CD4^(+)/CD8^(+)was calculated.The traditional Chinese medicine(TCM)syndrome before and after treatment and the piper fatigue scale(PFS-R)and universal core scale of children’s quality of life(Peds QL)were scored.The changes of white blood cells(WBC),red blood cells(RBC),hemoglobin(Hb)and platelets(PLT)were evaluated before and after treatment.Result:The nutritional status of the observation group was better than that of the control group after treatment(Z=2.018,P<0.05).The observed fatigue was lighter than that of the control group(Z=2.029,P<0.05).The MNA score of the observation group was higher than that of the control group(P<0.01).The scores of PFS-R and deficiency of both Qi and blood were lower than those of the control group(P<0.01).The CD4^(+)levels and CD4^(+)/CD8^(+)levels of TB,ALB and PAB in the observation group were higher than those in the control group(P<0.01),while the CD8^(+)was lower than the control group(P<0.01).The Ig M and Ig A levels in the observation group were higher than those in the control group(P<0.01).The RBC,Hb and PLT levels of the observation group were higher than those of the control group(P<0.01).Conclusion:Modified Shengmaiyin can be used as adjuvant therapy for childr

关 键 词：急性淋巴细胞白血病 气血两虚证 生脉饮 营养状况 疲乏程度 免疫功能 

分 类 号：R289[医药卫生—方剂学] R733.7[医药卫生—中药学]