升髓合剂防治化疗后骨髓抑制的临床研究

目的:观察患者临床症状、客观检测指标及用药期间是否出现不良反应等,评价升髓合剂对多西他赛联合顺铂方案(Docetaxel Combined with Cis-platinum,DP)化疗所致骨髓抑制的有效性及安全性。方法:将50例符合标准的恶性肿瘤患者随机分为两组,治疗组和对照组各25例。对照组:DP方案化疗同时加服地榆升白片,治疗组:在DP方案化疗基础上加用升髓合剂。2个周期后观察患者化疗后第3、7、14 d外周血细胞变化及骨髓抑制情况,化疗后中医临床症状评分及疗效以及体力状况评分(Karnofsky,KPS)、体质量变化及其不良反应。结果:①两组化疗完成率观察组明显高于对照组(P<0.05);②观察组血常规中白细胞、中性粒细胞、血小板计数治疗后1周与治疗前比较无统计学意义,(P>0.05),而对照组白细胞、中性粒细胞、血小板计数下降显著,与治疗前差异有统计学意义,(P<0.05);两组相比,化疗后1周观察组血常规白细胞、中性粒细胞、血小板水平明显高于对照组,差距有统计学意义(P<0.05);③化疗后2周观察组白细胞计数升高明显高于对照组,两组差异有显著性(P<0.05);④化疗后中医证候改善方面,观察组症状改善显著(P<0.05)。对照组症状上改善不明显(P>0.05),两组在总体症状改善率方面相比较有显著性差异,治疗组明显优于对照组(P<0.05);⑤治疗组KPS评分明显优于对照组(P<0.05);⑥治疗组不良反应的发生率明显低于对照组(P<0.05)。结论:升髓合剂对于多西他赛联合顺铂化疗方案引起的骨髓抑制等不良反应具有防治作用。

Study on Shengsui Mixture on bone marrow suppression caused bychemotherapy

Objective: To observe the clinical symptoms, objective detection indexes and adverse reactions during the administration,and to evaluate the efficacy and safety of Shengsui Mixture ( 升 髓 合 剂 ) on bone marrow suppression caused by docetaxel combinedwith cisplatin( abbreviated as DP scheme) chemotherapy. Methods:50 patients with malignant tumors were randomly divided into twogroups, with 25 in the treatment group and 25 in the control group. The control group received the DP scheme chemotherapy with theDiyu Shengbai troche( 地榆升白片 ). The treatment group received the Shengsui mixture on the basis of the DP scheme chemotherapy.After two cycles, the peripheral blood cell changes and myelosuppression of the patients on the 3rd, 7th and 14th day after chemotherapywere observed. The clinical symptom score and efficacy of the TCM and the physical status score (KPS score), body weight change andtheir side e ffects were analyzed.Results: ① The observation rate of chemotherapy in the treatment group was signi ficantly higher thanthat in the control group (P<0.05). ② In the observation group, white blood cells, neutrophils, and platelet counts were not statisticallysignificant 1 week after treatment and before treatment (P>0.05). The white blood cells, neutrophils and platelet counts of the controlgroup decreased signi ficantly, and the di fference was statistically signi ficant before treatment, P<0.05. Compared with the control group,the white blood cells, neutrophils and platelet levels were signi ficantly higher in the observation group 1 week after chemotherapy, thedifference was statistically significant (P<0.05). ③ 2 weeks after chemotherapy, the white blood cell count in the observation group wassignificantly higher than that in the control group. The difference between the two groups was significant (P<0.05). ④ In the improvementof TCM symptom after chemotherapy, the symptoms in the observation group improved signi ficantly (P<0.05), and the improvement inthe symptoms of the control group was not obvious (P>0.05). There was a significant difference in the overall symptom improvement ratebetween the two groups. The treatment group was significantly better than the control group (P<0.05). ⑤ The quality of life KPS score inthe treatment group was significantly better than that of the control group (P<0.05). ⑥ The incidence of side effects in the treatment groupwas signi ficantly lower than that in the control group (P<0.05).Conclusion: Shengsui Mixture has a preventive and therapeutic e ffect onadverse reactions such as myelosuppression caused by docetaxel combined with cisplatin chemotherapy.