去甲基化分层疗法联合复方君子汤治疗老年急性髓系白血病临床研究  

Clinical Study on Demethylation Stratification Therapy Combined with Compound Junzi Tang for Senile Acute Myeloid Leukemia

作　　者：梁春灵 廖斌[1] 皇甫真萍[1] 齐彦[1] 陈毅宁[1] 陈佳薇[1] 徐成波[1] 陈泽松 LIANG Chunling;LIAO Bin;HUANGFU Zhenping;QI Yan;CHEN Yining;CHEN Jiawei;XU Chengbo;CHEN Zesong

机构地区：[1]福建中医药大学附属人民医院血液科,福建福州350004

出　　处：《新中医》2021年第24期132-136,共5页New Chinese Medicine

基　　金：福建中医药大学校管课题临床专项(XB2019039);福建省中青年教师教育科研项目(JAT190245)。

摘　　要：目的:回顾性分析去甲基化分层疗法联合复方君子汤治疗老年急性髓系白血病(AML)的临床疗效及安全性。方法:将78例老年AML患者根据治疗意愿分为观察组40例及对照组38例,对照组采用标准剂量地西他滨联合CAG方案行去甲基化治疗,观察组根据年龄、合并症、体力状况采用去甲基化分层疗法(不同剂量地西他滨)联合复方君子汤治疗,以(28±4)d为1个疗程,至少完成2个疗程。评价2组患者的近期疗效、中医证候疗效、远期生存情况及治疗的安全性。结果:治疗2个疗程后,观察组近期疗效总缓解率与中医证候疗效总有效率均高于对照组(P<0.05)。观察组平均生存时间长于对照组(P<0.05)。观察组不良反应发生率低于对照组(P<0.05)。结论:去甲基化分层疗法联合复方君子汤治疗可以增加老年AML患者对去甲基化治疗的耐受性,减少不良反应,延长总生存期及无复发生存期。Objective:To conduct a retrospective analysis of the clinical effect and safety of demethylation stratification therapy combined with compound Junzi tang for senile acute myeloid leukemia(AML).Methods:A total of 78 cases of senile AML patients were divided into the observation group and the control group according to their treatment intentions,40 and 38 cases in each group respectively.The control group was treated with standard dose of decitabine and CAG plan for demethylation.The observation group was treated with demethylation stratification therapy with different doses of decitabine,considering their ages,complications and physical conditions,and combined with compound Junzi tang.Both groups were treated for at least two courses,28±4 days being a course.The short-term curative effects,curative effect of Chinese medicine syndromes,long-term survival and treatment safety in the two groups were evaluated.Results:After two courses of treatment,the total remission rate of short-term curative effect and total effective rate of Chinese medicine syndromes in the observation group were higher than those in the control group(P<0.05).The average survival time in the observation group was longer than that in the control group(P<0.05).The incidence of adverse reactions in the observation group was lower than that in the control group(P<0.05).Conclusion:Demethylation stratification therapy combined with compound Junzi tang can increase the tolerance of demethylation therapy of the senile AML patients,reduce adverse reactions,and prolong the overall survival and recurrence-free survival.

关 键 词：急性髓系白血病 老年人 复方君子汤 地西他滨 去甲基化分层疗法 

分 类 号：R733.71[医药卫生—肿瘤]