益髓生血丸辅助治疗恶性肿瘤化疗后骨髓抑制气阴两虚证患者40例临床观察  

Yisui Shengxue Pills(益髓生血丸)as Adjuvant Treatment for Myelosuppression after Chemotherapy for 40 Patients of Malignant Tumours with Qi and Yin Deficiency Syndrome:A Randomised Controlled Trial

作　　者：焦宁[1] 张登山[1] 师丽娜 毛毛[1] 谭国昌 JIAO Ning;ZHANG Dengshan;SHI Lina;MAO Mao;TAN Guochang(Hospital of Traditional Chinese Medicine of Zibo City,Shandong Province,255300)

机构地区：[1]淄博市中医医院,山东省淄博市255300

出　　处：《中医杂志》2024年第19期2018-2024,共7页Journal of Traditional Chinese Medicine

基　　金：山东省中医药科技项目(2020M113);淄博市人才孵育计划(2022156)。

摘　　要：目的 观察益髓生血丸对恶性肿瘤化疗后骨髓抑制气阴两虚证患者的临床疗效、安全性,并探讨其可能作用机制。方法 80例恶性肿瘤化疗后骨髓抑制气阴两虚证患者随机分为观察组和对照组,每组40例。两组均给予常规西医治疗,对照组在此基础上加用安慰剂口服,观察组加用益髓生血丸口服,两组均连续治疗21天。分别于治疗前后检测两组粒细胞集落刺激因子(G-CSF)、粒细胞-巨噬细胞集落刺激因子(GM-CSF)、可溶性细胞间黏附分子-1 (sICAM-1)、齿状蛋白1 (Jagl)、Notch同源物2 (Notch2)、细胞命运决定因子膜相关蛋白1 (Numb1)、中性粒细胞、血小板计数、白细胞计数、血红蛋白、CD4^(+)、CD8^(+)水平;治疗前后评价两组骨髓抑制分级及中医症状评分,比较两组临床疗效及不良反应发生情况。结果 治疗后两组间骨髓抑制分级比较差异有统计学意义(P<0.05)。与本组治疗前比较,两组患者治疗后血浆G-CSF、GM-CSF、sICAM-1、Numb1表达、血小板计数、中性粒细胞计数、白细胞计数、血红蛋白、CD4^(+)水平降低,Jagl、Notch2表达和CD8^(+)水平升高,神疲乏力、自汗、心悸、盗汗、失眠、面色少华、口糜、五心烦热评分均降低(P<0.05)。与对照组治疗后比较,观察组患者血浆G-CSF、GM-CSF、sICAM-1、Numb1表达、血小板计数、中性粒细胞计数、白细胞计数、血红蛋白、CD4^(+)水平升高,Jagl、Notch2表达和CD8^(+)水平降低,神疲乏力、自汗、心悸、盗汗、失眠、面色少华、口糜、五心烦热评分均降低(P<0.05)。观察组总有效率为95.00%,明显高于对照组的80.00%(P<0.05)。两组肝功能损伤、肾功能损伤发生率比较,差异无统计学意义(P>0.05),观察组胃肠道损伤发生率低于对照组(P=0.02)。结论 益髓生血丸辅助治疗恶性肿瘤化疗后骨髓抑制气阴两虚证患者可改善其骨髓抑制情况和临床症状,提高临床疗效,具有良好的增效减�Objectives To observe the clinical effectiveness,safety,and potential mechanism of Yisui Shengxue Pills(益髓生血丸)as adjuvant treatment for myelosuppression after chemotherapy for malignant tumours with qi and yin deficiency syndrome.Methods Eighty patients of myelosuppression after chemotherapy for malignant tumours with qi and yin deficiency syndrome were randomly divided into trial group and control group,with 40 cases in each group.Both groups received conventional western medicine treatment,while the control group added placebo taken orally,and the trial group received Yisui Shengxue Pills orally,and both groups were treated for 21 consecutive days.Granulocyte colony stimulating factor(G-CSF),granulocyte-macrophage colony stimulating factor(GM-CSF),soluble intercellular cell adhesion molecule-1(sICAM-1),Jagged 1(Jagl),Notch homolog 2(Notch2),cell fate determinant membrane associated protein 1(Numb1),neutrophils,platelet count,white blood cell count,hemoglobin,cluster of differentiation 4+(CD4^(+)),and cluster of differentiation 8+(CD8^(+))were detected before and after treatment;myelosuppression grade and TCM syndrome scores of the two groups were evaluated before and after treatment,and clinical effectiveness and adverse events of the two groups were compared.Results The difference in myelosuppression grading between the two groups after treatment was statistically significant(P<0.05).Compared with this group before treatment,plasma G-CSF,GM-CSF,sICAM-1,Numb1 expression,platelet count,neutrophil count,leukocyte count,haemoglobin,CD4^(+)level decreased,Jagl,Notch2 expression and CD8^(+)level increased,and fatigue,spontaneous sweating,palpitation,night sweating,insomnia,scanty complexion,mouth erosion,vexing heat in chest,palms and soles scores all reduced(P<0.05).Compared with the control group after treatment,plasma G-CSF,GM-CSF,sICAM-1,Numb1 expression,platelet count,neutrophil count,leukocyte count,haemoglobin,CD4^(+)levels increased,Jagl,Notch2 expression and CD8^(+)levels decreased,and fatigue,spo

关 键 词：恶性肿瘤 化疗 骨髓抑制 气阴两虚证 益髓生血丸 NOTCH信号通路 免疫功能 

分 类 号：R273[医药卫生—中西医结合]