宣痹消瘤方联合硼替佐米治疗多发性骨髓瘤的临床观察  

Clinical Effect of Xuanbi Xiaoliu Decoction Combined with Bortezomib in Treatment of Multiple Myeloma

作　　者：冯小苏 杨雯豪 王启慧 于慧[1] 孔祥图[1] 杨烨[2] 倪海雯[1] FENG Xiaosu;YANG Wenhao;WANG Qihui;YU Hui;KONG Xiangtu;YANG Ye;Ni Haiwen(The Affiliated Hospital of Nanjing University of Chinese Medicine,Jiangsu Nanjing 210029,China;Nanjing University of Chinese Medicine,Jiangsu Nanjing 210029,China)

机构地区：[1]南京中医药大学附属医院,江苏南京210029 [2]南京中医药大学,江苏南京210029

出　　处：《安徽中医药大学学报》2025年第1期15-20,共6页Journal of Anhui University of Chinese Medicine

基　　金：国家中医药管理局第四批全国中医优秀人才研修项目(国中医药办人教函〔2017〕24号);江苏省基础研究计划—攀登项目(BK20240003)。

摘　　要：目的观察宣痹消瘤方联合硼替佐米治疗多发性骨髓瘤(multiple myeloma,MM)的临床疗效。方法将80例肾虚血瘀型MM患者随机分为观察组和对照组,每组40例。两组均接受硼替佐米治疗的基础方案,观察组加用宣痹消瘤方,21 d为1个疗程,共4个疗程。比较两组患者治疗前后中医证候积分、欧洲癌症研究与治疗组织生活质量核心量表(European organization for research and treatment of cancer quality of life questionnaire core 30,EORTC QLQ-C30)评分、生活质量问卷多发性骨髓瘤模块(Quality of life multiple myeloma questionnaire,QLQ-MY20)评分以及临床疗效和不良反应发生情况。结果治疗后两组患者中医证候积分中的瘀、痰、虚、睡眠、饮食维度评分及总分均较治疗前显著减少(P<0.05),观察组热维度评分较治疗前显著降低(P<0.05),且治疗后观察组中医证候积分中瘀、虚、睡眠、饮食维度评分及总分均显著低于对照组(P<0.05)。治疗后两组患者EORTC QLQ-C30量表中疲乏、疼痛、呼吸困难、睡眠障碍、经济压力评分均较治疗前显著降低(P<0.05),躯体功能、角色功能、情绪功能、认知功能、社会功能、整体生活质量评分均较治疗前显著增加(P<0.05),且治疗后观察组躯体功能、整体生活质量评分均显著高于对照组(P<0.05),疲乏、食欲减退、便秘评分均显著低于对照组(P<0.05)。治疗后两组患者QLQ-MY20量表中疾病症状、治疗不良反应评分均较治疗前显著降低(P<0.05),身体意象、未来期望评分均显著增加(P<0.05),且治疗后观察组治疗不良反应评分显著低于对照组(P<0.05)。两组患者临床疗效比较,差异无统计学意义(P>0.05)。观察组胃肠道反应发生率、肺部感染发生率均显著低于对照组(P<0.05)。结论宣痹消瘤方联合硼替佐米治疗MM,可显著改善患者中医证候,提高患者生活质量,降低不良反应发生率。Objective To investigate the clinical effect of Xuanbi Xiaoliu Decoction combined with bortezomib as the basic treatment regimen for multiple myeloma(MM).Methods A total of 80 MM patients with kidney deficiency and blood stasis were randomly divided into observation group and control group,with 40 patients in each group.Both groups received the basic treatment regimen with bortezomib,and the patients in the observation group received Xuanbi Xiaoliu Decoction in addition to the basic treatment regimen.Each course of treatment was 21 days,and both groups were treated for 4 courses.The two groups were compared in terms of traditional Chinese medicine(TCM)syndrome score,European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30(EORTC QLQ-C30)score,Quality of Life Multiple Myeloma Questionnaire(QLQ-MY20)score,clinical outcome,and adverse reactions.Results After treatment,both groups had significant reductions in total TCM syndrome score and the scores of stasis,deficiency,sleep,and diet(P<0.05),and the observation group had significantly lower scores than the control group(P<0.05).After treatment,both groups had significant reductions in the scores of fatigue,pain,dyspnea,sleep disorders,and financial difficulties(P<0.05)and significant increases in the scores of physical function,role function,emotional function,cognitive function,and social function and the total quality of life score in the EORTC QLQ-C30 scale(P<0.05),and compared with the control group,the observation group had significantly higher score of physical function and total quality of life score and significantly lower scores of fatigue,loss of appetite,constipation(P<0.05).As for the QLQ-MY20 scale,both groups had significant reductions in the scores of disease symptoms and treatment-related adverse reactions(P<0.05)and significant increases in the scores of body image and future perspective(P<0.05)after treatment,and compared with the control group,the observation group had significantly higher scores of significa

关 键 词：宣痹消瘤方 多发性骨髓瘤 肾虚血瘀证 硼替佐米 

分 类 号：R733.3[医药卫生—肿瘤]