益气养阴清热法辅助治疗急性髓系白血病临床疗效观察

目的 探讨益气养阴清热法与化疗结合治疗急性髓系白血病的临床疗效。方法 114例患者随机分为治疗组68例和对照组46例。治疗组中医药以益气养阴清热法为基本治法。诱导缓解以DA、HA、MA、IA等联合化疗方案及急性早幼粒细胞白血病(M3)患者应用维甲酸、亚砷酸治疗。对照组仅用上述西药治疗。结果 治疗组完全缓解49例(72．1％)，部分缓解9例(13．2％)，总缓解率85．3％，与对照组比较，差异有显著性(P<0．01)。两组治疗后血象及骨髓像均有明显改善，血红蛋白及血小板的升高及骨髓白血病细胞数的降低治疗组优于对照组(P<0．05或P<0．01)；两组治疗后免疫功能均有提高，CD4、CD4／CD8比值的升高治疗组优于对照组(均P<0．05)；NK细胞活性的提高治疗组优于对照组(P<0．01)。结论 益气养阴清热法辅助治疗急性髓系白血病提高了临床疗效，有比较高的实用价值。

Clinical Observation on Treatment of Acute Myelocytic Leukemia by Supplementing Qi, Nourishing Yin and Clearing Heat Principle

To observe the clinical efficacy of TCM with supplementing Qi, nourishing Yin and clearing heat principle (SQNYCH) combined with chemotherapy in treating myelocytic leukemia. Methods One hundred and fourteen patients were randomly divided into the treated group (n =68) and the control group ( n=46). To the treated group, SQNYCH was applied as the basic treatment, with combined chemotherapeutic protocol, using DA, HA and IA, to induce remission, and to the M3 patients, all-trans retinoic acid and arsenic tri-oxide were given. As for patients in the control group, only western medicine was administered. Results In the treated group 49 patients (72. 1%) were completely remitted, 9 (13.2%) partially remitted and the total remission rate being 85.3% , which was significantly different from that in the control group. After treatment, the blood and bone marrow picture were obviously improved in both groups, but the increase of hemoglobin and platelet were better in the treated group than in the control group (P<0.05 or P<0.01). Immune functions were enhanced in both groups, but the elevation of CD4, CD4/CD8 ratio and NK cells were higher in the treated group than in the control group (P<0.05 and P<0.01). Conclusion Application of SQNYCH principle in treating acute myelocytic leukemia could elevate the clinical efficacy, which is of great value in clinical practice.