补肾强骨方治疗多发性骨髓瘤临床观察

目的观察补肾强骨方对多发性骨髓瘤(MM)巨噬细胞移动抑制因子(MIF)的骨髓影响及临床疗效,为临床推广应用提供依据。方法选择符合纳入标准的多发性骨髓瘤患者30例,随机分为2组,治疗组用补肾强骨方联合VAD化疗方案,对照组用沙利度胺联合VAD化疗方案,观察治疗前后患者血浆MIF水平、血红蛋白、血清M蛋白、骨髓浆细胞比例、血清钙、血β2微球蛋白(β2-MG)、乳酸脱氢酶(LDH)、C-反应蛋白(CRP)指标变化,并统计临床疗效,分析不良反应。结果治疗组、对照组治疗前后血浆MIF水平、血红蛋白、M蛋白、骨髓浆细胞比例、CRP比较,具有统计学意义,P0.01;血β2-MG比较,具有统计学意义,P0.05;血钙、血LDH比较,无统计学意义,P0.05。治疗组总有效率达86.66%,对照组总有效率达80%,经Ridit统计分析,无明显差异,P0.05。治疗过程中便秘、嗜睡、浮肿、外周神经病变的2组比较,有统计学意义,P0.05。结论补肾强骨方治疗MM疗效与沙利度胺相似,可以降低血浆MIF水平,提升血红蛋白,降低M蛋白、浆细胞比例、血β2-MG、CRP,且不良反应明显减少。表明补肾强骨方对MM治疗具有一定优势,可抑制MM血浆MIF的高表达、抑制血管新生。

Clinical observation of Bushen Qianggu Decoction on multiple myeloma

Objective To observe the effects of Bushen Qianggu Decoction(BQD)onmacrophagemigra-tion inhibitory factor(MIF)of patients with multiple myeloma(MM)and its clinical efficacy,so as to pro-videthegroundforclinicalpromotion.Methods 30patientswhoaccordedwiththeinclusivecriteria were divided into two groups randomly.BQD combined with VAD chemotherapy regimen were used in treatment group;thalidomide combined with VAD chemotherapy regimen were used in control group.The indexes of pre-and post-treatment were observed,including serum MIF,hemoglobin,serum M protein, marrow plasmacyte rate,serum calcium,serum β2 microglobulin (β2-MG),lactic acid dehydrogenase (LDH),and C-reaction protein (CRP).And the clinical efficacy and adverse reaction were studied. Results There were statistical differences between treatment group and control group in serum MIF,he-moglobin,serum Mprotein,marrow plasmacyte rate,CRP (P<0.01)and β2-MG (P<0.05).There was no difference in serum calcium and LDH (P>0.05).The total effective rate in treatment group was 86.66% compared to 80% in control group,no significant differences after Ridit analysis (P>0.05). The incidence of constipation,sleepiness,edema,peripheral neuropathy of control group were signifi-cantlyhigherthanthatoftreatmentgroup(P<0.05).Conclusion Theclinical efficacy of BQDon MM was close to thalidomide with obviously less adverse reactions.BQD decreased serum MIF,M pro-tein,marrow plasmacyte rate,serum β2-MG,and CRP,increased hemoglobin,and adverse reactions were decreased significantly.This study showed that BQD has certain advantages on MM by the way of inhibiting the high expression of serum MIF and angiogenesis.