生血清毒汤辅助治疗急性白血病30例

目的:探讨生血清毒汤辅助治疗急性白血病的减毒增效作用。方法:60例急性白血病患者采用随机按住院顺序分为对照组和观察组各30例,对照组急性非淋巴细胞白血病采用DA方案(柔红霉素+阿糖胞苷);急性淋巴细胞白血病采用VALP方案(长春新碱+柔红霉素+左旋门冬酰胺酶+强的松);并给予相应的对症辅助治疗。观察组在对照组治疗的基础上加用生血清毒汤辨证加减,1剂/d,化疗开始后同期服用,化疗结束后继续服用4周。监测化疗前及化疗结束后患者肝肾功能、凝血功能及外周血象;化疗结束后4周内外周血象三系恢复正常情况;采用流式细胞仪法检测化疗前和化疗后4周外周血T淋巴细胞亚群和NK细胞水平。结果:观察组总有效率为83.33%,优于对照组的56.67%(P<0.05);化疗后两组肝功能丙氨酸转氨酶(ALT)和天冬氨酸转氨酶(AST)、肾功能血尿素氮(BUN)和血肌酐(Scr)较化疗前下降(P<0.01)。观察组低于对照组(P<0.01);两组化疗后外周血血红蛋白(Hb)和血小板(PLT)较化疗前上升(P<0.01),观察组上升更为显著(P<0.01);化疗后两组凝血功能指标凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、凝血酶时间(TT)、纤维蛋白原(FIB)均较治疗前下降,观察组PT,APTT和FIB低于对照组(P<0.01);化疗后4周观察组Hb,PLT和NK恢复正常例数多于对照组(P<0.05);化疗后4周观察组CD3+,CD4+,CD4+/CD8+和NK水平高于对照组(P<0.01)。结论:生血清毒汤能减轻化疗对急性白血病患者的肝功能损害,能减轻化疗对骨髓造血功能的抑制作用,能调节患者凝血功能,改善出血症状,能调节细胞免疫功能,增强机体的抗肿瘤能力,起到良好的减毒、增效作用。

Adjuvant of Shengxue Qingdu Decoction in Treating Acute Leukemia with 30 Cases

Objective: Discussed synergism and attenuation function of adjuvant of Shengxue Qingdu decoction in treating acute leukemia. Method: Sixty patients with acute leukemia were randomly divided into control group (30 cases) and observation group (30 cases) according to the order in hospital.Patients with acute non-lymphocytic leukemia in the control group received daunorubicin and cytosine arabinoside as DA scheme.patients with lymphocytic leukemia received vincristine,daunorubicin,L-asparaginase and prednisone by VALP method.Each group received corresponding auxiliary symptomatic treatment.Based on the treatment of control group,patients in the observation group added dialectical treatment of addition and subtraction of Shengxue Qingdu decoction,1 dose/day,taken along with chemotherapy and continued taking for 4 weeks after the ending of chemotherapy.Before and after the ending of chemotherapy,patients' hepar and renal function,blood coagulation and peripheral hemogram were monitored.At the forth week after the ending of chemotherapy,condition of returning to normal of inner and peripheral hemogram three-line were monitored.Before chemotherapy and at the forth week after chemotherapy,level of T lymphocyte subgroups of peripheral blood and natural killer cell(NK) were detected by flow cytometer. Result: The total effective rate in the observation group was 83.33% superior to 56.67% in the control group(P<0.05).After chemotherapy,compared with the time before chemotherapy,liver function glutamic-pyruvic transaminase and glutamic oxalacetic transaminase and renal function(blood urea nitrogen and serum creatinine decreased(P<0.01),but which in observation group were lower than those in control group(P<0.01).Hemoglobin(HB) of peripheral blood and platelet(PLT) increased(P<0.01),the degree of increasing in observation group was more significant than in control group(P<0.01).Index of blood coagulation such as prothrombin time(PT),activated partial thromboplastin time(APTT),thrombin time(TT) and fibrinogen(FIB) were decreased,PT,APTT and FIB in observation group were lower than those in control group(P<0.01).At the forth week after chemotherapy,cases of returning to normal of Hb,PLT and NK in observation group were more than those in control group(P<0.05).Levels of CD3⁺,CD4⁺,CD4⁺/CD8⁺ and NK in observation group were higher than those in control group(P<0.01). Conclusion: Shengxue Qingdu decoction can reduce patients' damage of hepatic function of chemotherapy in treating acute leukemia and the inhibition of chemotherapy to medullary hematopoiesis,and it can adjust patients' blood coagulation,ameliorate symptom of bleeding,adjust cellular immune function and improve anti-tumor ability of bodies,and there is a good synergism and attenuation function.