苦参碱治疗多发性骨髓瘤的疗效分析

目的:分析苦参碱治疗多发性骨髓瘤(MM)的疗效和毒副作用。方法:将74例MM患者分为2组:长春新碱+阿霉素+地塞米松(VAD)组35例,给予基础治疗,苦参碱+VAD组39例,在基础治疗的基础上给予苦参碱,28d为1个疗程。以胸片、心电图、骨髓穿刺结果、血清免疫球蛋白水平、血清免疫固定电泳、血尿本周氏蛋白电泳、24h尿蛋白定量、肝肾功能与全血细胞计数检查结果为指标,根据美国国立综合癌症网络(NCCN)2009年国际骨髓瘤工作组(IMWG)标准疗效判断标准(疗效评估分为完全缓解(CR)、非常好的部分缓解(VGPR)、部分缓解(PR)、稳定(SD)和疾病进展(PD))进行疗效评估,并统计不良反应。结果:苦参碱+VAD组和VAD组CR患者比例分别为12.8%和8.6%,无显著性差异;VGPR患者比例分别为33.3%和11.4%,有显著性差异(P<0.05);PR患者比例分别为46.2%和45.7%,无显著性差异;苦参碱+VAD组恶心呕吐、乏力、发热出现的比率显著低于VAD组(P<0.05),出现腹部不适的比例2组间比较无显著性差异;两组均未出现心动过速、化疗相关死亡情况。结论:苦参碱有助于提高多发性骨髓的缓解率与减少化疗相关不良反应。

Analysis of Therapeutic Efficacy of Matrine in the Treatment of Multiple Myeloma

OBJECTIVE：To analyze the therapeutic efficacy and toxic side effects of matrine in the treatment of multiple myeloma（MM）.METHODS：74 MM patients were analyzed retrospectively and divided into 2 groups：35 cases were given primary treatment in vincristine＋adriacin＋ dexamethasone（VAD） group and 39 cases were additionally given matrine on the basis of VAD group in matrine＋VAD group.One treatment course lasted for 28 days.Therapeutic efficacy was evaluated using chest radiograph,electrocardiogram,bone nail,The serum levels of immunoglobulin,immunofixa-tion electrophoresis,BJ protein electrophoresis,24 h proteinuria excretion,liver and kidney function and complete blood count as index.According to the NCCN 2009 IMWG） tandard curative effect judgment standard,efficacy assessment was divided into complete remission（CR）,a very good partial remission（VGPR）,partial remission（PR）,stability（SD） and disease progression（PD）.Adverse drug reaction and abdominal discomfort were analyzed statistically.RESULTS：Matrine＋VAD group and VAD group CR were respectively 12.8% and 8.6%,with no significant difference（P0.05）;VGPR were respectively 33.3% and 11.4%,there was significant difference（P0.05）;PR were respectively 46.2% and 45.7%,with no significant difference（P0.05） matrine ＋ VAD group;nausea and vomiting,fatigue,fever,the ratio was significantly lower than that of VAD group（P0.05）,abdominal discomfort and the ratio between the 2 groups had no significant difference（P0.05）;the two groups had no heartbeat tachycardia,chemotherapy related death.CONCLUSION：Matrine can improve remission rate of MM and reduce adverse drug reactions related to chemotherapy.