中西医结合治疗急性髓系白血病疗效观察

【作者】 王亚军；

【导师】 苏伟；

【作者基本信息】 北京中医药大学 ， 中西医结合临床， 2010， 硕士

【摘要】 目的：探讨中西医结合治疗方法对急性髓系白血病的临床疗效。方法：采用回顾性资料分析方法,对20例初治急性髓系白血病患者病例资料进行临床疗效总结和研究对比,并根据治疗中是否使用中药将患者分为[中药+化疗组](简称治疗组)和[单纯化疗组](简称对照组)。观察诱导缓解期白血病患者的临床治疗效果,主要从临床疗效(完全缓解率、有效率、中医证候改善情况)；支持疗法(血制品输注均量、粒细胞集落刺激因子使用均量)；化疗药物毒副作用等方面进行观察对比,分析中药参与治疗后有无治疗优势?结果：1、两组完全缓解率及有效率分别为50%和60%,60%和70%,治疗组完全缓解率及有效率均低于对照组,经统计学检验,.两组数据无明显差异(P>0.05)。治疗组中医证候改善情况其症状量化积分明显减少,治疗前后积分比较存在统计学差异(P<0.05)。2、化疗过程中两组患者均出现骨髓抑制,输注血制品方面,红细胞输注均量治疗组明显少于对照组,经比较有统计学差异(P<0.05),治疗组的血小板输注均量及粒细胞集落刺激因子使用均量少于对照组,经检验两组数据无统计学差异(P>0.05)。3、化疗过程中出现副作用比较,其中肝损害发生率两组分别为30%和80%,治疗组明显低于对照组,经统计学检验,两组数据有明显差异(P<0.05)。结论：1．中西医结合治疗急性髓系白血病,中药在支持疗法中显示出一定优势,可以减少患者的输血用量；在刺激骨髓恢复正常造血功能方面,中药具体作用机制本项研究尚无法确定,有待于积累更多的病例资料和开展相关实验研究进一步观察验证.2.中药在减轻化疗药物的毒副作用方面初见端倪,本项研究显示中药可减少化疗药物肝损害的发生率；对心脏和肾脏有无保护作用由于本项研究样本数太小、观察周期较短,目前尚无结果,有待于进一步观察。3.中药参与治疗在提高白血病CR率方面有无优势?本项研究尚不能确定。更多还原

【Abstract】 Objective:To investigate the efficacy of the combined treatment of traditional Chinese Medicine (TCM) and western medicine for acute myelogenous leukemia (AML)Methods:The method of retrospective statistical analysis was employed here to study 20 patients with AML to make clinic data summary and comparison. The patients were separated into two groups, the Chinese medicine-chemotherapy group (also called treatment group) and the chemotherapy group (also called control group) according to the use of Chinese traditional medicine during the treatment. To observe the efficacy of remission induction therapy and to make comparison mainly from the aspects of clinical efficacy (complete remission rate, efficacy and TCM symptomatic improvement); supportive treatment (both the average amount of blood products transfusion and granulocyte colony-stimulating factor being used) and the chemotherapy side effects. Analyze the advantages of participation of traditional Chinese medicine.Results:1. The complete remission rates and effective rates of the two groups are 50% and 60%,60% and70%, and we could see that the complete remission rate and effective rate of treatment group are inferior to the control group, and there were no significant differences between the two sets of data according to statistical tests. (P>0.05) The symptomatic improvement and the quantization points significantly reduced and there was significant differences before and after the treatment (P<0.05).2. During the chemotherapy, bone marrow suppression could be seen in both groups of patients; the treatment group was inferior to the control group in the average amount of blood transfusion during the chemotherapy and there were significant difference between the two groups (P<0.05); the treatment group was inferior to the control group in the G-CSF and platelet transfusion average volumes and there were no significant differences between the two groups (P>0.05)3. To compare the side effects during the chemotherapy. The incidences of hepatic damage of the two groups are 30% and 80% respectively, from which we could see the incidence of treatment group is much lower than that of the control group and there was significant difference (P< 0.05)Conclusion:1. During the combined treatment of traditional Chinese Medicine and western medicine for acute leukemia, Chinese medicine shows some advantages in decreasing the blood transfusion. But we don’t know whether it has advantages in stimulating the recovery of the hematopoiesis, which needs more clinical experiences and intensive observation and verification.2. The efficacy of Chinese medicine in reducing the toxic side effects of chemotherapy drugs began to be seen. This study shows traditional Chinese medicine can reduce the incidence of liver damage of chemotherapy. We can’t conclude about whether the Chinese medicine has protection effects on heart and kidneys from this study because the sample size was small and the observation period was short.3. The advantage of Chinese medicine in improve the CR rate of leukemia requires further study.更多还原