益肾生血汤防治急性髓系白血病化疗后骨髓抑制临床研究

目的探讨益肾生血汤对急性髓系白血病化疗后骨髓抑制患者骨髓抑制发生情况的影响。方法将符合入选标准的2018年6月-2020年3月北京市隆福医院血液科患者60例采用随机数字表法分为2组,每组30例。对照组给予常规支持治疗,观察组在对照组基础上加服自拟益肾生血汤。2组均治疗2周。分别于治疗前后进行症状、体征评分,观察化疗后出现Ⅳ度骨髓抑制的时间和持续时间,记录治疗期间重组人粒细胞集落刺激因子(granulocyte colony stimulating factor,G-CSF)注射次数及输血量,以及治疗期间的不良反应。结果观察组Ⅳ度骨髓抑制出现时间(5.07±0.87)d比(3.83±1.15)d,t=4.695]晚于对照组(P<0.01)、持续时间(7.20±0.76)d比(10.03±1.30)d,t=10.305]低于对照组(P<0.01);观察组重组人G-CSF注射次数(7.2±0.8)次比(10.0±1.3)次,t=10.305]少于对照组(P<0.01),红细胞悬液红细胞(2.5±1.5)U比(4.7±1.5)U,t=7.749]及血小板(1.70±0.54)U比(3.13±0.86)U,t=5.879]输注量少于对照组(P<0.01);观察组治疗后1、2周症状、体征评分低于对照组(t值分别为18.208、15.129,P值均<0.01);观察组化疗后感染、出血、心电图异常的发生率低于对照组(χ²值分别为7.500、10.000、4.286,P值均<0.01)。结论益肾生血汤有助于延缓骨髓抑制的发生时间,可促进骨髓抑制的恢复,减少骨髓抑制期的不良反应,提高生命质量。

Clinical study of Yishen-Shengxue Decoction on the prevention and treatment of bone marrow suppression in acute myeloid leukemia after chemotherapy

Objective To study the clinical effects of Yishen-Shengxue Decoction on the prevention and treatment of bone marrow suppression in acute myeloid leukemia after chemotherapy.Methods A total of 60 patients in Beijing Longfu Hospital from June 2018 to March 2020 were randomly divided into control group and observation group,30 cases in each group.The control group was treated with western medicine and blood transfusion,while the observation group was treated with Yishen-Shengxue Decoction on the basis of the control group.Both groups were treated for 2 weeks.We recorded the occurrence time and duration ofⅣdegree myelosuppression of the two groups,compared the score of symptoms and signs,injection volume of recombinant human granulocyte colony stimulating factor(G-CSF)and blood transfusion volume,and recorded the incidence of adverse reactions after chemotherapy.Results The occurrence of myelosuppression in the observation group was significantly later than that of the control group(5.07±0.87 d vs.3.83±1.15 d;t=4.695,P<0.01),and the duration of grade myelosuppression was significantly shorter than that ofⅣthe control group(7.20±0.76 d vs.10.03±1.30 d;t=10.305,P<0.01);The quantity of granulocyte colony stimulating factor injection in the observation group was significantly less than that of the control group(7.2±0.8 vs.10.0±1.3,t=10.305),and the quantity of red blood cell suspension(2.5±1.5 U vs.4.7±1.5 U,t=7.749)and platelet transfusion(1.7±0.5 U vs.3.1±0.9 U,t=5.879)were significantly less than that of the control group(P<0.01);the quantitative score of symptoms and signs in the observation group were significantly lower than thoseof the control group(t values were 18.208,15.129,respectively,all Ps<0.01).The adverse reactions of the patients in the observation group after chemotherapy were significantly less than those of the control group,and the incidence of infection,bleeding and ECG abnormalities were statistically significant(χ² values were 7.500,10.000,4.286,respectively,all Ps<0.01).Conclusion Yishen-Shengxue Decoction is helpful to delay the occurrence of myelosuppression,and promote its recovery,reduce various adverse reactions during myelosuppression,and improve the quality of life.