黄芪通络汤治疗痰瘀痹阻型多发性骨髓瘤临床研究  

Clinical Study on Huangqi Tongluo Decoction(黄芪通络汤)in Treatment of Multiple Myeloma with Phlegm and Blood Stasis Obstruction Syndrome

作　　者：李睿嘉 李静[2] 张倩倩[2] 王海妹 李晓红[2] LI Ruijia;LI Jing;ZHANG Qianqian;WANG Haimei;LI Xiaohong(Graduate School of Hebei University of Chinese Medicine,Shijiazhuang 050200,China;Hematology Department of Hebei Hospital of Traditional Chinese Medicine,Shijiazhuang 050011,China;Surgery Department of Chengde Hospital of Traditional Chinese Medicine,Chengde 067300,China)

机构地区：[1]河北中医药大学研究生院,河北石家庄050200 [2]河北省中医院血液病科,河北石家庄050011 [3]承德市中医院外科,河北承德067300

出　　处：《山东中医杂志》2023年第7期719-724,共6页Shandong Journal of Traditional Chinese Medicine

基　　金：河北省中医药管理局科研计划项目(编号:2019037,2018009)。

摘　　要：目的:观察黄芪通络汤治疗痰瘀痹阻型多发性骨髓瘤的疗效,并通过血栓弹力图(TEG)和常规凝血指标评估本方对患者血液高凝状态的影响。方法:将70例痰瘀痹阻型多发性骨髓瘤患者随机分为对照组和观察组各35例,对照组予来那度胺、硼替佐米联合地塞米松(RVD方案)治疗,观察组予黄芪通络汤联合RVD方案治疗。比较两组患者临床疗效、中医证候疗效、常规凝血指标水平、TEG参数水平、不良反应情况。结果:治疗后,观察组临床疗效、中医证候疗效均优于对照组(P<0.05)。两组患者血浆凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)均较治疗前延长,D-二聚体(D-D)、血浆纤维蛋白原(FIB)水平均较治疗前下降(P<0.05),且观察组患者PT、APTT长于对照组(P<0.05),D-D、FIB水平低于对照组(P<0.05)。TEG检测显示,两组患者血细胞凝集时间(K值)较治疗前上升(P<0.05),α角、综合凝血指数(CI)较治疗前下降(P<0.05),观察组患者血凝块最大强度(MA)较治疗前下降(P<0.05),且观察组患者K值高于对照组(P<0.05),MA、α角、CI低于对照组(P<0.05)。治疗期间,观察组不良反应总发生率低于对照组,两组不良反应情况比较,差异有统计学意义(P<0.05)。结论:黄芪通络汤联合RVD方案治疗痰瘀痹阻型多发性骨髓瘤疗效确切,可有效改善患者血液高凝状态,降低静脉血栓形成风险。Objective:To observe the curative efficacy of Huangqi Tongluo Decoction(黄芪通络汤)on multiple myeloma with phlegm and blood stasis obstruction syndrome,and to evaluate the effect of this prescription on blood hypercoagulability of the patients by means of thrombelastogram(TEG)and conventional coagulation indicators.Methods:A total of 70 multiple myeloma patients with phlegm and blood stasis obstruction syndrome were randomly divided into control group and observation group,with 35 patients in each group.The control group was treated with lenalidomide,bortezomib,and dexamethasone(RVD regimen),and the observation group was treated with Huangqi Tongluo Decoction combined with RVD regimen.The clinical curative efficacy,curative efficacy on traditional Chinese medicine(TCM)syndrome,levels of conventional coagulation indicators,levels of TEG parameters and adverse reactions were compared between the two groups.Results:After treatment,the clinical curative efficacy and curative efficacy on TCM syndrome in the observation group were better than those in the control group(P<0.05).In the two groups,the prothrombin time(PT)and activated partial thrombin time(APTT)after treatment were longer than those before treatment,and the levels of D-dimer(D-D)and plasma fibrinogen(FIB)after treatment were lower than those before treatment(P<0.05).After treatment,the PT and the APTT in the observation group were longer than those in the control group(P<0.05),and the levels of D-D and FIB in the observation group were lower than those in the control group(P<0.05).The TEG test showed that the time of hemagglutination(K value)in the two groups was increased compared with that before treatment(P<0.05),theαangle and the coagulation index(CI)in the two groups were decreased compared with those before treatment(P<0.05),and the maximum amplitude(MA)in the observation group was decreased compared with that before treatment(P<0.05).After treatment,the K value in the observation group was higher than that in the control group(P<0.05),and th

关 键 词：黄芪通络汤 多发性骨髓瘤 痰瘀痹阻 血栓弹力图 高凝状态 静脉血栓形成 

分 类 号：R273[医药卫生—中西医结合]