补肾解毒化瘀方联合CPT化疗方案治疗老年多发性骨髓瘤临床观察
Clinical Effect of Kidney-tonifying, Detoxicating, and Stasis-resolving Prescription Combined with CPT Chemotherapy Regimen in Treatment of Elderly Multiple Myeloma
  
DOI:
中文关键词:  补肾解毒化瘀法  CPT化疗方案  生活质量  多发性骨髓瘤
英文关键词:Kidney-tonifying, detoxicating, and stasis-resolving method  CPT chemotherapy regimen  Quality of life  Multiple myeloma
基金项目:江苏省优秀青年人才专项课题(YX1201)
作者单位
倪海雯,姜鹏君,孔祥图 江苏省中医院血液科江苏 南京 210029 
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中文摘要:
      目的 观察补肾解毒化瘀方联合CPT化疗方案治疗老年多发性骨髓瘤的临床疗效及其对免疫功能的影响。方法 将40例老年多发性骨髓瘤患者随机分为治疗组与对照组,每组20例,两组均采用CPT化疗方案,28 d为1个周期,6个周期评价疗效;治疗组同时加用补肾解毒化瘀方治疗。观察临床疗效、生活质量变化及中医临床症状改善情况,治疗前后分别观察血管内皮生长因子(vascular endothelial growth factor, VEGF)、白细胞介素-6(interleukin-6, IL-6)及调节性T细胞的水平变化情况。结果 治疗组与对照组近期疗效分布差异无统计学意义(P>0.05);治疗组骨痛缓解效果显著优于对照组(P<0.05);治疗组生活质量改善效果优于对照组(P<0.05);中医临床证候改善方面,治疗组优于对照组(P<0.05)。治疗前两组VEGF、IL-6水平差异无统计学意义(P>0.05),治疗3个月及6个月后均显著下降(P<0.05),且治疗组VEGF、IL-6水平较对照组下降显著(P<0.05)。调节性T细胞表达比较,治疗前患者CD4+CD25+、CD4+CD25high、CD4+CD25highCD127low细胞比例均显著升高(P<0.05),但治疗后两组细胞比例均显著下降(P<0.05),且治疗组细胞比例较对照组下降更明显(P<0.05)。结论 补肾解毒化瘀方联合CPT化疗方案治疗多发性骨髓瘤有助于改善患者临床症状,提高免疫功能。
英文摘要:
      Objective To investigate the clinical effect of kidney-tonifying, detoxicating, and stasis-resolving prescription combined with CPT chemotherapy regimen in the treatment of elderly multiple myeloma and its influence on immune function. Methods A total of 40 patients with elderly multiple myeloma were randomly divided into treatment group and control group, with 20 patients in each group. The patients in both groups received CPT chemotherapy, with 28 days as one cycle, and the clinical outcome was evaluated after 6 cycles. The patients in the treatment group were given kidney-tonifying, detoxicating, and stasis-resolving prescription in addition. The clinical outcome, change in quality of life, and improvement in TCM clinical symptoms were observed, and the levels of vascular endothelial growth factor (VEGF) and interleukin-6 (IL-6) and the percentage of regulatory T cells were measured before and after treatment. Results There was no significant difference in short-term clinical outcome between the treatment group and the control group (P>0.05). Compared with the control group, the treatment group had significantly better improvements in bone pain, quality of life, and TCM clinical symptoms (P<0.05). There were no significant differences in the levels of VEGF and IL-6 between the two groups before treatment (P>0.05); both groups had significant reductions in the levels of VEGF and IL-6 after 3 and 6 months of treatment (P<0.05), and the treatment group had significantly greater reductions compared with the control group (P<0.05). As for regulatory T cells, both groups had significant increases in the percentages of CD4+CD25+, CD4+CD25high, and CD4+CD25highCD127low T cells before treatment (P<0.05) and significant reductions in these cells after treatment (P<0.05), and the treatment group had significantly greater reductions compared with the control group (P<0.05). Conclusion In the treatment of elderly multiple myeloma, kidney-tonifying, detoxicating, and stasis-resolving prescription combined with CPT chemotherapy regimen helps to improve patients clinical symptoms and increase immune function.
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