化痰活血方治疗痰瘀痹阻型多发性骨髓瘤疗效及对患者血管内皮生长因子的影响

目的:观察化痰活血方对痰瘀痹阻型多发性骨髓瘤(MM)的疗效及血管内皮生长因子(VEGF)表达水平的影响。方法:选取60例痰瘀痹阻证MM患者,以随机数字表法分为两组。对照组予硼替佐米联合地塞米松(VD方案); 观察组予化痰活血方联合VD方案。4个疗程后比较两组疾病控制率(DCR)、总有效率(ORR)、不良反应发生率、血清VEGF变化水平、骨痛评分(VAS)、卡氏生活质量评分(KPS)和日常生活活动能力评分(ADL)。结果:观察组西医疗效ORR高于对照组(P<0.05),两组DCR比较,差异无统计学意义(P>0.05); 观察组中医证候疗效ORR高于对照组(P<0.05); 治疗后两组VAS及血清VEGF水平均较前降低,且观察组评分和血清VEGF水平低于对照组(P<0.05); 两组KPS、ADL均较前升高,且观察组评分高于对照组(P<0.05); 观察组不良反应发生率低于对照组(P<0.05)。结论:化痰活血方对痰瘀痹阻型MM患者疗效显著,可明显降低VEGF水平和不良反应发生率,改善生存质量。

Huatan Huoxue decoction in treatment of multiple myeloma of phlegm and blood stasis syndrome and its effect on VEGF

Objective:To observe the effect of Huatan Huoxue decoction on the clinical efficacy and the level of VEGF in patients with multiple myeloma(MM)of phlegm and blood stasis syndrome.Methods:60 patients with MM of phlegm and blood stasis syndrome treated in department of hematology were randomly divided into two groups.The control group were treated with bortezomib and dexamethasone(VD chemotherapy).The observation group were treated with Huatan Huoxue decoction combined with VD chemotherapy.After 4 courses of treatment,compared the two groups in the disease control rate(DCR),overall response(ORR),incidence of adverse reactions and the changes of VAS,KPS,ADL and VEGF level.Results:The ORR of western medicine curative effect of the observation group were higher than those of the control group(P<0.05).There was no difference in DCR between the two groups(P>0.05).The ORR of TCM syndrome of the observation group was higher than those in the control group(P<0.05).After treatment,VAS of the two groups decreased and these scores of observation group decreased more obviously(P<0.05).The level of VEGF in both groups decreased,and that in the observation group was lower(P<0.05).KPS and ADL of the two groups were higher than before,and these scores of observation group rose more obviously(P<0.05).The incidence of adverse reactions in the observation group was lower than that in the control group(P<0.05).Conclusion:Huatan Huoxue decoction has obvious clinical effect on patients with MM of phlegm and blood stasis syndrome.It can obviously reduce the level of VEGF,the incidence of adverse reactions and improve the quality of life.