青黄散加补肾健脾中药治疗骨髓增生异常综合征的临床观察

目的 观察青黄散加补肾健脾中药治疗骨髓增生异常综合征（MDS）的临床疗效。方法 55例MDS患者给予青黄散、补肾健脾汤药及雄性激素等治疗。结果 55例MDS患者中，完全缓解11例（20.0%），总有效41例（74.5%）。根据FAB分型，RA/RAS型34例，完全缓解9例（26.5%），总有效28例（82.4%）；RAEB型21例，完全缓解2例（9.5%），总有效13例（61.9%），两型间疗效比较差异无统计学意义。按国际预后积分系统(IPSS)评定标准，中危Ⅰ组36例，有效25例（其中完全缓解10例），无效11例。中危Ⅱ组7例，完全缓解1例，有效4例，无效2例。高危组6例，完全缓解0例，有效3例，无效3例。3组疗效比较差异无统计学意义。有效者41例，治疗后白细胞、血红蛋白和血小板计数均较治疗前升高（P＜0.05）；染色体异常组16例，有效11例(68.8%)；染色体正常组33例，有效24例(72.7%)；染色体异常与否间疗效比较，差异无统计学意义。结论 化瘀补肾为主综合治疗MDS具有确切的临床疗效，疗效与FAB分型、IPSS积分及染色体异常与否无明显相关性。

Effect of Treatment for Myelodysplastic Syndrome by Qinghuang Powder Combined with Chinese Herbs for Reinforcing Shen and Strenghening

OBJECTIVE: To observe the clinical efficacy of Qinghuang Powder combined with Chinese herbs for reinforcing Shen and strenghening Pi in treating myelodysplastic syndrome (MDS). METHODS: fifty-five patients with diagnosis fitting to MDS were treated with Qinghuang Powder and decoction for strengthening Pi and reinforcing Shen, in combination with Stanozololum. RESULTS: Eleven patients (20.0%) out of the 55 were completely remitted (CR), the total effective rate being 74.5% (41/55 cases). By FAB typing, 9 (26. 5%) in the 34 patients of type RA/RAS were CR, with the total effective rate of 82.4% (28/34 cases), and in the 21 patients of type RAEB, 9.5% (2/21 cases) were CR with the total effective rate of 61.9% (13/21 cases), showing insignificant statistical difference between the two types (P > 0.05). By international prognostic scoring system (IPSS), the treatment was evaluated as CR in 10 patients, effective in 25 and ineffective in 11 in 36 patients of moderate risk group I , the responding numbers were 1, 4, 2 in 7 patients of moderate risk group II and 0, 3, 3 in 6 patients of high risk group, respectively, also showing insignificant difference between groups (P > 0.05). Levels of Hb, WBC and platelet significantly increased after treatment (P < 0. 05). By cytogenetics, the effective rate was 68.8% (11/16 cases) in patients with abnormal chromosome and 72.7% (24/33 cases) in those with normal chromosome, with insignificant difference (P > 0.05). CONCLUSION: The comprehensive therapy with TCM treatment for reinforcing Shen and dissolving stasis in dominance has a definite clinical effect in treating MDS, it was not significantly associated with FAB typing, IPSS score, and chromosome abnormality of patients.