益气养阴清热法合化疗治疗急性髓细胞白血病

目的 :探讨益气养阴清热法为基本治法配合化疗治疗急性髓细胞白血病的临床疗效。方法 :用黄芪、太子参、白术、生地、黄精、天门冬、麦门冬、白花蛇舌草、半枝莲、小蓟、蒲公英、甘草组方。配合 DA、HA、IA等联合化疗方案。部分 M3 患者应用维甲酸、亚砷酸治疗。部分患者静脉滴注榄香稀乳、参脉、丹参等辅助治疗。结果 :1 5 6例完全缓解 1 1 3例 ,完全缓解率 72 .4% ;部分缓解 2 0例 ,部分缓解率 1 2 .8% ;总缓解率 85 .3% ;3年生存率 37.2 % ,5年生存率 2 2 .1 %。 32例老年患者完全缓解率 43.8% ,明显低于其他年龄段 ( P<0 .0 1 )。应用维甲酸治疗的 1 8例 M3 完全缓解 1 5例 ,完全缓解率 83.3%。亚砷酸治疗 3例完全缓解 2例。结论 :益气养阴清热法作为中医的基本治法治疗急性髓细胞白血病符合临床实际。中西医结合治疗急性髓细胞白血病缓解率高 ,患者易于接受 ,有比较高的实用价值。其中提示老年患者治疗比较困难。

Treating Acute Myeloid Leukemia with Yiqiyangyinqingri Methods and Chemical Medicine

Objective: To investigate the clinical curative effect of Yiqiyangyinqingri methods complicated with chemical medicine on treating acute myeloid leukemia. Methods:The Traditional Chinese Medicines were composed of Huangqi, Taizishen, Baishu, Shengdi, Huangjing, Tianmendong, Maimendong, Baihuasheshecao, Banzhilian, Xiaoji, Pugongymg and Gancao, which were complicated with DA, HA and IA for chemical treatment. Some patients with M3 were treated by retinoic acid or arsenicals.Results: Among 156 cases of acute myeloid leukemia, 113 cases were completely relieved(rate with 72.4%), 20 cases partly relieved(rate with 12.8%), total relieved rate with 85.3%. And 3 year prolife rate was 37.2%, 5 year prolffe rate 22.1%. The completely relieved rate of 32 cases of aged acute myeloid leukemia was 43.8%, markedly lower than those of other age periods ( P <0.01). The completely relieved rate of 18 cases treated with retinoic was 83.3%,while 2 of 3 cases with arsenicals were completely relieved. Conclusion:Yiqiyangyinqingri methods, as the basic Traditional Chinese Medical treatment ways, can meet the clinical necessary well on treating acute myeloid leukemia. Treating acute myeloid leukemia with integration of Traditional and Western medicine can gain a higher relieved rate, which is easily accepted by patients, and owns higher clinical value. Meanwhile, it suggests that the aged patients with acute myeloid leukemia are difficult to treat.