补血方联合造血刺激治疗相对高危骨髓增生异常综合征患者的疗效观察  

Clinical Efficacy of Buxue Formula Combined with Hematopoietic Stimulation in the Treatment of Patients with Higher-Risk Myelodysplastic Syndrome

作　　者：代喜平[1] 王国征[1] 林双[1] 吴远彬[1] 胡永珍[1] 李达[1] DAI Xi-ping;WANG Guo-zheng;LIN Shuang;WU Yuan-bin;HU Yong-zhen;LI Da(Guangdong Provincial Hospital of Traditional Chinese Medicine,Guangzhou Guangdong 510120)

机构地区：[1]广东省中医院,广东广州510120

出　　处：《世界中西医结合杂志》2023年第5期965-969,974,共6页World Journal of Integrated Traditional and Western Medicine

基　　金：广东省中医药局科研项目(20181113,2018KT1163)。

摘　　要：目的 评价补血方联合造血刺激治疗相对高危骨髓增生异常综合征(Myelodysplastic syndromes, MDS)的临床疗效。方法 选取2008年4月—2021年2月期间广东省中医院收治的相对高危(IPSS-R积分>3.5分)MDS患者30例,按随机数字表法分为中药组13例和化疗组17例。中药组采用补血方联合造血刺激治疗,化疗组常规化疗方案。治疗6个月后,观察比较两组患者生存期、血液学反应和血液学改善、疾病缓解、疾病稳定,以及血细胞计数[血红蛋白(Hemoglobin, HGB)、血小板(Platelet, PLT)、中性粒细胞(Absolute neutrophil count, ANC)]、输血依赖改善[脱离红细胞输血(Red blood cell transfusion independence, RBC-TI)、脱离血小板输血(Platelet transfusion independence, PLT-TI)]及随访情况。结果 中药组中位治疗时间为12个月,中位OS为12(6~95)个月,化疗组中位治疗疗程为4个疗程,中位OS为19(5~93)个月,两组患者中位OS比较,差异无统计学意义(P>0.05);中药组疾病稳定(SD)5例(38.5%),血液学改善(HI)6例(46.2%),治疗失败(TF)6例(46.2%),总有效率(ORR)为53.8%,化疗组骨髓缓解(mCR)3例(17.6%),SD5例(29.4%),HI4例(23.5%),TF8例(47.1%),ORR为52.9%,两组患者ORR、HI率比较,差异无统计学意义(P>0.05)。中药组脱离红细胞输血(RBC-TI)率为44.4%,脱离血小板输血(PLT-TI)率为50%,化疗组RBC-TI率为21.4%,PLT-TI率为20%,两组患者RBC-TI、PLT-TI率比较,差异无统计学意义(P>0.05)。结论 补血方联合造血刺激与常规方案治疗相对高危MDS的疗效相近,可作为相对高危MDS的可行性治疗方案。Objective To evaluate the clinical efficacy of Buxue Formula combined with hematopoietic stimulation in the treatment of high-risk myelodysplastic syndrome(MDS).Methods Thirty patients with high-risk MDS(IPSS-R score>3.5 points)treated at Guangdong Provincial Hospital of Traditional Chinese Medicine from April 2008 to February 2021 were enrolled and randomly divided into a Chinese medicine group(n=13)and a chemotherapy group(n=17).The Chinese medicine group received Buxue Formula treatment combined with hematopoietic stimulation,while the chemotherapy group received conventional chemotherapy.After 6 months of treatment,the survival period,hematological re-sponse,and hematological improvement(HI)[disease remission,stabilization of disease(SD),and blood cell counts,inclu-ding hemoglobin(HGB),platelet(PLT),and absolute neutrophil count(ANC)],improvement in transfusion dependence[red blood cell transfusion independence(RBC-TI)and platelet transfusion independence(PLT-TI)],and follow-up outcomes were observed and compared between the two groups.Results The median duration of treatment in the Chinese medicine group was 12 months,with a median overall survival(OS)of 12(6-95)months.In the chemotherapy group,the median duration of treatment was 4 courses,with a median OS of 19(5-93)months.There was no statistically significant difference in median OS between the two groups(P>0.05).In the Chinese medicine group,five cases(38.5%)showed SD,six cases(46.2%)showed HI,and six cases(46.2%)were classified as treatment failure(TF),resulting in an overall response rate(ORR)of 53.8%.In the chemotherapy group,three cases(17.6%)achieved marrow complete remission(mCR),five cases(29.4%)showed SD,four cases(23.5%)showed HI,and eight cases(47.1%)were classified as TF,resulting in an ORR of 52.9%.There was no statistically significant differences in ORR and HI rate between the two groups(P>0.05).The RBC-TI rate in the Chinese medicine group was 44.4%,and the PLT-TI rate was 50%.In the chemotherapy group,the RBC-TI rate was 21.4%and the PLT

关 键 词：骨髓增生异常综合征 补血方 总体生存 

分 类 号：R551.3[医药卫生—血液循环系统疾病]