河北医药
河北醫藥
하북의약
HEBEI MEDICAL JOURNAL
2013年
21期
3215-3217
,共3页
刘清池%马亚辉%张慧敏%庞宇慧%马传宝%王荣孝%陈伟%熊建军%谢勇%张振会%梁春耕%吴维海
劉清池%馬亞輝%張慧敏%龐宇慧%馬傳寶%王榮孝%陳偉%熊建軍%謝勇%張振會%樑春耕%吳維海
류청지%마아휘%장혜민%방우혜%마전보%왕영효%진위%웅건군%사용%장진회%량춘경%오유해
骨髓增生异常综合征%再生方,补肾中药%细胞形态学
骨髓增生異常綜閤徵%再生方,補腎中藥%細胞形態學
골수증생이상종합정%재생방,보신중약%세포형태학
myelodysplastic syndrome%regeneration formula,TCM of invigorating kidneyt%cell morphology
目的：观察中药再生方治疗治疗低危MDS的疗效及安全性。方法2008年2月至2010年7月低危MDS60例，按WHO诊断和分型，其中RA12例，RCMD42例，RAS2例，MDS-U 4例。随机分为再生方组与对照组，每组30例。再生方组应用再生方，水煎服，日一剂。对照组给予司坦唑醇，2 mg，3次/d，口服，或十一酸睾丸酮40 mg，2次/d，口服。治疗期间患者如有感染发热及时应用抗菌药物，贫血严重或出血明显时输注红细胞悬液或血小板，并统计血细胞输注数量。结果再生方组完全缓解3例、部分缓解3例、血液学改善14例，总有效率66 T．7％。对照组部分缓解2例、血液学改善9例，总有效率36．7％。2组疗效比较差异有统计学意义（χ2＝5．41， P ＜0．05）。细胞形态观察，中药再生方治疗低危MDS，可以使红系病态造血减轻。再生方组红细胞输注量为（15±10）U，对照组为（22±15）U，2组比较红细胞输注量差异有统计学意义（ t ＝2．18， P ＜0．05）。再生方组血小板输注量为（6±4）U（1人份为1 U），对照组为（13±6）U，2组比较差异有统计学意义（ t ＝2．31， P ＜0．05）。再生方组4例发生不良反应，发生率为13．3％，均为轻微的消化道反应，未发现肝肾功能损害。对照组30例有20例发生各种不良反应，发生率为66．7％。2组不良反应发生率差异有统计学意义（χ2＝17．78， P ＜0．01）。结论再生方治疗低危MDS有较好疗效，有效率高于雄性激素类药物，并减少红血细胞和血小板输注，无严重不良反应。形态学观察再生方可改善红系病态造血，使红细胞和血红蛋白显著改善。
目的：觀察中藥再生方治療治療低危MDS的療效及安全性。方法2008年2月至2010年7月低危MDS60例，按WHO診斷和分型，其中RA12例，RCMD42例，RAS2例，MDS-U 4例。隨機分為再生方組與對照組，每組30例。再生方組應用再生方，水煎服，日一劑。對照組給予司坦唑醇，2 mg，3次/d，口服，或十一痠睪汍酮40 mg，2次/d，口服。治療期間患者如有感染髮熱及時應用抗菌藥物，貧血嚴重或齣血明顯時輸註紅細胞懸液或血小闆，併統計血細胞輸註數量。結果再生方組完全緩解3例、部分緩解3例、血液學改善14例，總有效率66 T．7％。對照組部分緩解2例、血液學改善9例，總有效率36．7％。2組療效比較差異有統計學意義（χ2＝5．41， P ＜0．05）。細胞形態觀察，中藥再生方治療低危MDS，可以使紅繫病態造血減輕。再生方組紅細胞輸註量為（15±10）U，對照組為（22±15）U，2組比較紅細胞輸註量差異有統計學意義（ t ＝2．18， P ＜0．05）。再生方組血小闆輸註量為（6±4）U（1人份為1 U），對照組為（13±6）U，2組比較差異有統計學意義（ t ＝2．31， P ＜0．05）。再生方組4例髮生不良反應，髮生率為13．3％，均為輕微的消化道反應，未髮現肝腎功能損害。對照組30例有20例髮生各種不良反應，髮生率為66．7％。2組不良反應髮生率差異有統計學意義（χ2＝17．78， P ＜0．01）。結論再生方治療低危MDS有較好療效，有效率高于雄性激素類藥物，併減少紅血細胞和血小闆輸註，無嚴重不良反應。形態學觀察再生方可改善紅繫病態造血，使紅細胞和血紅蛋白顯著改善。
목적：관찰중약재생방치료치료저위MDS적료효급안전성。방법2008년2월지2010년7월저위MDS60례，안WHO진단화분형，기중RA12례，RCMD42례，RAS2례，MDS-U 4례。수궤분위재생방조여대조조，매조30례。재생방조응용재생방，수전복，일일제。대조조급여사탄서순，2 mg，3차/d，구복，혹십일산고환동40 mg，2차/d，구복。치료기간환자여유감염발열급시응용항균약물，빈혈엄중혹출혈명현시수주홍세포현액혹혈소판，병통계혈세포수주수량。결과재생방조완전완해3례、부분완해3례、혈액학개선14례，총유효솔66 T．7％。대조조부분완해2례、혈액학개선9례，총유효솔36．7％。2조료효비교차이유통계학의의（χ2＝5．41， P ＜0．05）。세포형태관찰，중약재생방치료저위MDS，가이사홍계병태조혈감경。재생방조홍세포수주량위（15±10）U，대조조위（22±15）U，2조비교홍세포수주량차이유통계학의의（ t ＝2．18， P ＜0．05）。재생방조혈소판수주량위（6±4）U（1인빈위1 U），대조조위（13±6）U，2조비교차이유통계학의의（ t ＝2．31， P ＜0．05）。재생방조4례발생불량반응，발생솔위13．3％，균위경미적소화도반응，미발현간신공능손해。대조조30례유20례발생각충불량반응，발생솔위66．7％。2조불량반응발생솔차이유통계학의의（χ2＝17．78， P ＜0．01）。결론재생방치료저위MDS유교호료효，유효솔고우웅성격소류약물，병감소홍혈세포화혈소판수주，무엄중불량반응。형태학관찰재생방가개선홍계병태조혈，사홍세포화혈홍단백현저개선。
Objective To observe the therapeutic effect and safety of regeneration formula on low-risk myelodysplastic syndromes ( MDS) .Methods Sixty patients with low-risk MDS who were inpatients or outpatients from February 2008 to July 2010 were enrolled in the study ,including 12 cases of RA ,42 cases of RCMD ,2 cases of RAS,4 cases of MDS-U according to the criterion of diagnosis and typing of WHO .These patients were randomly divided into treatment group ( n =30) and control group ( n =30).The patients in treatment group were treated with regeneration formula which was decocted in water for oral dose ,one dose a day ,however ,the patients in control group were treated with stanozolol ,2mg once,3 times a day.The patients were given antibacterials in case of infectious fever,and they were injected with red cell suspension or platelets in case of sever anemia or obvious hemorrhage ,meanwhile the transfusion amount of red cell suspension or platelets was calculated .Results The total effective rates in treatment group and control group were 66.7%,36.7%,respectively,there was a significant difference between two groups ( P <0.05 ).Cell morphous observation results showed that erythron dyshaematopoiesis was relieved in treatment group .There was a significant difference in transfusion amount of red cell suspension between two groups ( P <0.05),so was in transfusion amount of platelets ( P <0.05).The adverse reactions were taken place in 4 patients of treatment group , and the incidence rate was 20%, but these adverse reactions were all mild digestive tract reaction ,and no injury of liver and kidney was found .However the adverse reactions were taken place in 20 patients of control group ,and the incidence rate was 66.7%,there was a significant difference between two groups ( P <0.01).Concluison The regeneration formula is effective in treating low-risk MDS,and its effective rate is higher than that of stanozolol ,furthermore,which can reduce the transfusion amount of red cell suspension or platelets , without severe adverse reactions .The regeneration formula can also improve erythron dyshaematopoiesis ,as a result,improve obviously red blood cells and hemoglobin .
