髓白1号方辅助化疗治疗急性髓细胞白血病临床研究
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摘要
目的观察髓白1号方辅助化疗治疗急性髓细胞白血病(AML)的临床疗效,及其对化疗毒副反应的改善情况。方法采用随机数字表法将60例AML患者随机分为治疗组与对照组各30例。对照组采用标准方案化疗(DA/IDA方案);治疗组在对照组基础上予髓白1号方,每日1剂,每日2次冲服。2组均3周为1个疗程,连续治疗2个疗程。比较2组客观缓解率、中医疗效、毒副反应及并发症。结果治疗组客观缓解率为83.3%(25/30)、对照组为66.7%(20/30),治疗组中医疗效总有效率为96.7%(29/30)、对照组为70.0%(21/30),治疗组均明显优于对照组(P<0.05)。与本组治疗前比较,2组治疗后WBC水平明显下降,Hb、RBC、PLT水平明显升高(P<0.05);2组治疗后比较,治疗组WBC水平明显低于对照组,Hb、RBC、PLT水平明显高于对照组(P<0.05)。治疗组消化道反应、肝功能损伤及感染类并发症发生率均低于对照组(P<0.05)。结论髓白1号方辅助化疗治疗AML可有效降低相关并发症,提高临床疗效,改善患者生存质量。
Objective To observe the clinical efficacy of Suibai No.1 Prescription combined with chemotherapy for the treatment of acute myeloid leukemia(AML) and its effects on chemotoxic side effects. Methods Totally 60 AML patients were divided into treatment group and control group according to random number table method, with 30 cases in each group. Patients in the control group were treated with international standard chemotherapy(DA or IDA scheme), and treatment group were given Suibai No.1 Prescription on the basis of the control group, one dosage per day, twice a day, dissolved. Three weeks were one treatment course and the treatment for both groups lasted for two courses. Objective remission rate, TCM efficacy, toxic side effects, and complications of both groups were compared. Results The objective remission rate was 83.3%(25/30) in the treatment group and 66.7%(20/30) in the control group. The total effective rate of TCM efficacy was 96.7%(29/30) in the treatment group and 70.0% in the control group(21/30). The treatment group was significantly better than the control group(P<0.05). Compared with before treatment, the WBC levels of the two groups decreased significantly, and the levels of Hb, RBC and PLT significantly increased(P<0.05). After treatment, the WBC level in the treatment group was significantly lower than that in the control group, and the levels of Hb, RBC and PLT were significantly higher than those in the control group(P<0.05). The incidence of gastrointestinal reactions, liver function damage and infection complications in the treatment group were lower than those in the control group(P<0.05). Conclusion Suibai No.1 Prescription combined with chemotherapy for the treatment of AML can effectively reduce the complications of AML and improve clinical efficacy and life quality of patients.
Objective To observe the clinical efficacy of Suibai No.1 Prescription combined with chemotherapy for the treatment of acute myeloid leukemia(AML) and its effects on chemotoxic side effects. Methods Totally 60 AML patients were divided into treatment group and control group according to random number table method, with 30 cases in each group. Patients in the control group were treated with international standard chemotherapy(DA or IDA scheme), and treatment group were given Suibai No.1 Prescription on the basis of the control group, one dosage per day, twice a day, dissolved. Three weeks were one treatment course and the treatment for both groups lasted for two courses. Objective remission rate, TCM efficacy, toxic side effects, and complications of both groups were compared. Results The objective remission rate was 83.3%(25/30) in the treatment group and 66.7%(20/30) in the control group. The total effective rate of TCM efficacy was 96.7%(29/30) in the treatment group and 70.0% in the control group(21/30). The treatment group was significantly better than the control group(P<0.05). Compared with before treatment, the WBC levels of the two groups decreased significantly, and the levels of Hb, RBC and PLT significantly increased(P<0.05). After treatment, the WBC level in the treatment group was significantly lower than that in the control group, and the levels of Hb, RBC and PLT were significantly higher than those in the control group(P<0.05). The incidence of gastrointestinal reactions, liver function damage and infection complications in the treatment group were lower than those in the control group(P<0.05). Conclusion Suibai No.1 Prescription combined with chemotherapy for the treatment of AML can effectively reduce the complications of AML and improve clinical efficacy and life quality of patients.
引文
[1]李小梅,焦顺昌.哈里森肿瘤学手册[M].北京:科学出版社,2017:693-694.
[2]沈梯,赵永强.血液病诊断及疗效标准(第4版)[M].北京:科学出版社,2018:87-110.
[3]储大同.当代肿瘤内科治疗方案评价(第3版)[M].北京:北京大学医学出版社,2010:381-382.
[4]郑莜萸.中药新药临床研究指导原则(试行)[M].北京:中国医药科技出版社,2002:223-224.
[5]周际昌.实用肿瘤内科学[M].北京:北京科学技术出版社,2013:445-446.
[6] WEI G, NI W, CHIAO W, et al. A meta-analysis of CAG(cytarabine,aclarubicin, G-CSF)regimen for the treatment of 1029 patients with acute myeloid leukemia and myelodysplastic syndrome[J]. J Hematol Oncol,2011,4:46.
[7]JIQ,DINGYH,SUNY,etal.Antineoplastic effects and mechanisms of micheliolide in acute myelogenous leukemia stem cells[J]. Oncotarget,2016,7(40):65012-65023.
[8] ATTAR E C, JOHNSON J L, AMREIN P C, et al. Bortezomib added to daunorubicin and cytarabine during induction therapy and to intermediate-dose cytarabine for consolidation in patients with previously untreated acute myeloid leukemia age 60 to 75 years:CALGB(Alliance)study 10502[J]. J Clin Oncol,2013,31(7):923-929.
[9] COWAN A J, LASZLO G S, ESTEY E H, et al. Antibody-based therapy of acute myeloid leukemia with gemtuzumab ozogamicin[J]. Front Biosci(Landmark Ed),2013,18:1311-1334.
[10] GANETSKY A. The role of decitabine for the treatment of acute myeloid leukemia[J]. Ann Pharmacother,2012,46(11):1511-1517.
[11]蔡植华,郑乃莹,柳子川.沙利度胺联合常规化疗治疗急性白血病的疗效观察[J].现代中西医结合杂志,2015,24(15):1631-1633.
[12] GRIFFITHS E A, BRADY W E, TAN W, et al. A phase I study of intermediate dose cytarabine in combination with lenalidomide in relapsed/refractory acute myeloid leukemia[J]. Leuk Res,2016,43:44-48.
[13]杨金坤.现代中医肿瘤学[M].上海:上海中医药大学出版社,2004:428-429.
[14]黄礼明.白血病的中医药诊治[M].北京:科学出版社,2010:153-155.
[15]闫理想,史哲新,杨向东,等.益气养阴方对白血病干细胞MDR1 mRNA和P-gp表达的影响[J].中国中西医结合杂志,2017,37(12):1491-1495.
[16]黄云胜,施志明,丁金芳.益气养阴法对肺癌患者外周血肿瘤免疫逃逸相关因子的影响[J].上海中医药大学学报,2007,21(3):48-51.
[17]陈智,林圣云,蒋剑平,等.白花蛇舌草对香豆酸组合物对急性髓系白血病细胞Kasumi-1生长抑制作用[J].中国中西医结合杂志,2017,37(9):1089-1094.
[2]沈梯,赵永强.血液病诊断及疗效标准(第4版)[M].北京:科学出版社,2018:87-110.
[3]储大同.当代肿瘤内科治疗方案评价(第3版)[M].北京:北京大学医学出版社,2010:381-382.
[4]郑莜萸.中药新药临床研究指导原则(试行)[M].北京:中国医药科技出版社,2002:223-224.
[5]周际昌.实用肿瘤内科学[M].北京:北京科学技术出版社,2013:445-446.
[6] WEI G, NI W, CHIAO W, et al. A meta-analysis of CAG(cytarabine,aclarubicin, G-CSF)regimen for the treatment of 1029 patients with acute myeloid leukemia and myelodysplastic syndrome[J]. J Hematol Oncol,2011,4:46.
[7]JIQ,DINGYH,SUNY,etal.Antineoplastic effects and mechanisms of micheliolide in acute myelogenous leukemia stem cells[J]. Oncotarget,2016,7(40):65012-65023.
[8] ATTAR E C, JOHNSON J L, AMREIN P C, et al. Bortezomib added to daunorubicin and cytarabine during induction therapy and to intermediate-dose cytarabine for consolidation in patients with previously untreated acute myeloid leukemia age 60 to 75 years:CALGB(Alliance)study 10502[J]. J Clin Oncol,2013,31(7):923-929.
[9] COWAN A J, LASZLO G S, ESTEY E H, et al. Antibody-based therapy of acute myeloid leukemia with gemtuzumab ozogamicin[J]. Front Biosci(Landmark Ed),2013,18:1311-1334.
[10] GANETSKY A. The role of decitabine for the treatment of acute myeloid leukemia[J]. Ann Pharmacother,2012,46(11):1511-1517.
[11]蔡植华,郑乃莹,柳子川.沙利度胺联合常规化疗治疗急性白血病的疗效观察[J].现代中西医结合杂志,2015,24(15):1631-1633.
[12] GRIFFITHS E A, BRADY W E, TAN W, et al. A phase I study of intermediate dose cytarabine in combination with lenalidomide in relapsed/refractory acute myeloid leukemia[J]. Leuk Res,2016,43:44-48.
[13]杨金坤.现代中医肿瘤学[M].上海:上海中医药大学出版社,2004:428-429.
[14]黄礼明.白血病的中医药诊治[M].北京:科学出版社,2010:153-155.
[15]闫理想,史哲新,杨向东,等.益气养阴方对白血病干细胞MDR1 mRNA和P-gp表达的影响[J].中国中西医结合杂志,2017,37(12):1491-1495.
[16]黄云胜,施志明,丁金芳.益气养阴法对肺癌患者外周血肿瘤免疫逃逸相关因子的影响[J].上海中医药大学学报,2007,21(3):48-51.
[17]陈智,林圣云,蒋剑平,等.白花蛇舌草对香豆酸组合物对急性髓系白血病细胞Kasumi-1生长抑制作用[J].中国中西医结合杂志,2017,37(9):1089-1094.