摘要
目的:探讨“髓毒”理论指导下益肾活血解毒汤联合VRD方案(硼替佐米+地塞米松+来那度胺)治疗多发性骨髓瘤的有效性及安全性。方法:选择126例多发性骨髓瘤患者,采用随机数字表法,将患者分为研究组与对照组63例。对照组给予标准VRD化疗方案治疗,研究组在对照组基础上联合益肾活血解毒汤治疗,比较两组患者总有效率、深度缓解率、治疗前后免疫生化指标[骨髓浆细胞比率、血M蛋白水平、β2微球蛋白(β2-M)、乳酸脱氢酶(LDH)]、中医证候积分、生活质量卡氏评分及安全性。结果:治疗后,研究组总有效率、深度缓解率明显优于对照组(P<0.05)。两组浆细胞比率、M蛋白、β2-M及LDH均较治疗前改善,组间比较,差异具有统计学意义(P<0.05)。两组中医证候疗效评分,生活质量卡氏评分治疗后较治疗前明显改善,组间比较,差异具有统计学意义(P<0.05)。研究组与对照组比较,不良反应发生率低(P<0.05)。结论:“髓毒”理论指导下益肾活血解毒汤联合VRD方案治疗多发性骨髓瘤,可显著改善患者症状,提高总缓解率,增加缓解深度,降低瘤负荷,减轻化疗不良反应,从而提高患者生活质量,具有良好的扶正、增效、减毒作用。
Objective:To explore the effectiveness and safety of Yishen Huoxue Jiedu Decoction(益肾活血解毒汤)combined with bortezomib,lenalidomide,dexamethasone(VRD)regimen in the treatment of multiple myeloma under the guidance of the“medullary toxicity”theory.Methods:Totally,126 patients with multiple myeloma were included and randomly divided into research group and control group according to random number table method,63 patients in each group,using random number table method.The control group was treated with standard VRD chemotherapy regimen,while the research group was treated with Yishen Huoxue Jiedu Decoction besides the treatment in the control group.The total effective rate,deep remission rate,disease control rate,immune and biochemical indicators[bone marrow plasma cell ratio,serum M protein level,β2 microglobulin(β2-MG),and lactate dehydrogenase(LDH)],traditional Chinese medicine(TCM)syndrome score,life quality score and safety in both groups were compared before and after treatment.Results:After treatment,the total effective rate and deep remission rate of the research group were significantly better than those of the control group(P<0.05).After treatment,plasma cell ratio,M proteinβBoth 2-MG and LDH improved compared to before treatment,and the difference between groups was statistically significant(P<0.05).The efficacy scores of two groups of traditional Chinese medicine syndromes,as well as the quality of life score,showed significant improvement after treatment compared to before.The difference between the groups was statistically significant(P<0.05).The research group had low incidence of adverse reactions(P<0.05).Conclusions:Under the guidance of the theory of“medullary toxicity”,combination of Yishen Huoxue Jiedu Decoction and VRD regimen can significantly improve the symptoms of patients with multiple myeloma,increase the overall remission rate,increase the depth of remission,reduce tumor burden,reduce chemotherapy adverse reactions,and thereby improve the life quality of patients,with good effect for tonifying healthy qi,increasing effectiveness and reducing toxicity.
作者
李迎巧
高二超
王凤林
王茂生
范华
周振环
周玉才
杨淑莲
LI Yingqiao;GAO Erchao;WANG Fenglin;WANG Maosheng;FAN Hua;ZHOU Zhenhuan;ZHOU Yucai;YANG Shulian(Langfang Hospital of Traditional Chinese Medicine,Langfang 065000,China;Sanhe Hospital of Traditional Chinese Medicine,Langfang 065200,China)
出处
《山东中医杂志》
2023年第12期1288-1294,共7页
Shandong Journal of Traditional Chinese Medicine
基金
全国名老中医药传承工作室建设项目(批文号:国中医药人教函〔2022〕75号)
第五批全国中医临床优秀人才研修项目(批文号:国中医药人教函〔2022〕1号)
河北省中医药管理局中医药类科研计划项目(编号:2020440)。
关键词
多发性骨髓瘤
益肾活血解毒汤
髓毒理论
化疗
VRD方案
M蛋白
中医证候积分
multiple myeloma
Yishen Huoxue Jiedu Decoction
chemotherapy
VRD regimen
M protein
syndrome score
integrated Chinese and western medicine
作者简介
李迎巧(1986—),女,河北衡水人,医学硕士,主治医师,主要从事中西医结合治疗血液病工作。电话:18031603225,邮箱:hengshuilyq@126.com。;通信作者:王茂生(1974—),男,河北廊坊人,医学硕士,主任医师,主要从事中西医结合治疗血液病工作。邮箱:wms65352003@163.com。
