含砷中药复方为主治疗高危骨髓增生异常综合征不良因素探析  

Adverse Factors in the Treatment of High-risk MDS with Arsenic-containing Chinese Medicine Compound Formulas

作　　者：靳楠 毛悦 吕妍[1] 陈卓 王德秀 刘为易 刘驰[1] 唐旭东[1] JIN Nan;MAO Yue;LYU Yan;CHEN Zhuo;WANG Dexiu;LIU Weiyi;LIU Chi;TANG Xudong(Xiyuan Hospital,China Academy of Chinese Medical Sciences,Beijing 100091,China;School of Clinical Medicine,Beijing University of Chinese Medicine,Beijing 100029,China)

机构地区：[1]中国中医科学院西苑医院,北京100091 [2]北京中医药大学临床医学院,北京100029

出　　处：《世界中医药》2025年第2期275-282,共8页World Chinese Medicine

基　　金：国家自然科学基金面上项目(82074258,82274502);第二批北京市研究型病房示范建设项目(BCRW202108);中国中医科学院科技创新工程重大攻关项目(CI2021A01701)。

摘　　要：目的:探讨含砷中药复方治疗高危骨髓增生异常综合征(HR-MDS)患者疗效的不良因素,筛选预测含砷中药复方治疗HR-MDS的疗效不良因素指标。方法:回顾性分析2016年1月至2022年9月中国中医科学院西苑医院确诊为HR-MDS的200例患者的一般资料、血常规、骨髓涂片与组织病理学、细胞遗传学等临床资料。结果:年龄≥60岁(P=0.015)、血小板计数<50×10^(9)/L(P=0.003)、MDS-AML(P=0.008)是含砷中药复方联合HMAs或雄激素治疗HR-MDS的疗效不良因素;年龄≥60岁(P=0.012)、血小板计数<50×10^(9)/L(P=0.004)、MDS进展为AML(MDS-AML)(P=0.008)是含砷中药复方联合HMAs或雄激素治疗HR-MDS疗效不良的独立危险因素。MDS-AML(P=0.011)、化疗疗程<5个(P=0.024)是含砷中药复方联合HMAs治疗HR-MDS的疗效不良因素;MDS-AML的比例(P=0.048)是含砷中药复方联合去甲基化药物(HMAs)治疗HR-MDS疗效不良的独立危险因素。年龄≥60岁(P=0.013)、血小板计数≥50×10^(9)/L(P=0.019)、MDS-AML(P=0.034)是含砷中药复方联合雄激素是治疗HR-MDS的疗效不良因素;年龄≥60岁(P=0.019)、血小板计数<50×10^(9)/L(P=0.04)、MDS-AML(P=0.041)是含砷中药复方联合雄激素治疗HR-MDS疗效不良的独立危险因素。结论:MDS-AML、化疗疗程<5个可作为含砷中药复方联合HMAs治疗HR-MDS的疗效不良指标;年龄≥60岁、血小板计数<50×10^(9)/L、MDS-AML是含砷中药复方联合雄激素治疗HR-MDS疗效不良指标。Objective:To investigate the adverse factors affecting the efficacy of arsenic-containing Chinese medicine compound formulas in the treatment of high-risk myelodysplastic syndrome(HR-MDS)and to identify predictive indicators of poor efficacy.Methods:A retrospective analysis was conducted on the clinical data of 200 HR-MDS patients diagnosed at Xiyuan Hospital,China Academy of Chinese Medical Sciences,between January 2016 and September 2022.Data included general patient information,routine blood tests,bone marrow smears,histopathology,and cytogenetics.Results:Age≥60 years(P=0.015),platelet count<50×10^(9)/L(P=0.003),and progression to MDS-AML(P=0.008)were identified as adverse factors affecting the efficacy of arsenic-containing Chinese medicine compound formulas combined with hypomethylating agents(HMAs)or androgens for HR-MDS treatment.Furthermore,age≥60 years(P=0.012),platelet count<50×10^(9)/L(P=0.004),and MDS progression to AML(MDS-AML)(P=0.008)were independent risk factors for poor efficacy in this treatment regimen.For patients receiving arsenic-containing Chinese medicine compound formulas combined with HMAs,MDS-AML(P=0.011)and chemotherapy cycles<5(P=0.024)were adverse factors,while MDS-AML proportion(P=0.048)was identified as an independent risk factor for poor efficacy.For patients treated with arsenic-containing Chinese medicine compound formulas combined with androgens,age≥60 years(P=0.013),platelet count≥50×10^(9)/L(P=0.019),and MDS-AML(P=0.034)were adverse factors.Additionally,age≥60 years(P=0.019),platelet count<50×10^(9)/L(P=0.04),and MDS-AML(P=0.041)were independent risk factors for poor efficacy in this treatment group.Conclusion:MDS-AML and chemotherapy cycles<5 can be considered as indicators of poor efficacy for arsenic-containing Chinese medicine compound formulas combined with HMAs in HR-MDS treatment.Additionally,age≥60 years,platelet count<50×10^(9)/L,and MDS-AML are indicators of poor efficacy when arsenic-containing Chinese medicine compound formulas are combined with a

关 键 词：高危骨髓增生异常综合征 血液疾病 含砷中药复方 去甲基化药物 雄激素 疗效分析 预测指标 不良因素 

分 类 号：R289.5[医药卫生—方剂学] R551[医药卫生—中药学]