Clinical study of Bazhen Decoction combined with decitabine and CAG chemotherapy in the treatment of elderly acute myeloid leukemia

Xiaoliang ZHANG; Hui QU; Tao JIANG; Ping WANG; Baowen LIU

doi:10.16305/j.1007-1334.2021.2010074

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Clinical study of Bazhen Decoction combined with decitabine and CAG chemotherapy in the treatment of elderly acute myeloid leukemia

更新时间：2022-08-03

- Clinical study of Bazhen Decoction combined with decitabine and CAG chemotherapy in the treatment of elderly acute myeloid leukemia
- Shanghai Journal of Traditional Chinese Medicine Vol. 55, Issue 4, Pages: 55-59(2021)
- 作者机构：
  
  1.辽宁中医药大学第一临床学院（辽宁　沈阳　110847）
  2.辽宁中医药大学附属医院血液科（辽宁　沈阳　110032）
  3.中国医科大学附属第一医院老年呼吸科（辽宁　沈阳　110001）
- 作者简介：
- 基金信息：
- DOI：10.16305/j.1007-1334.2021.2010074
  CLC：
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Xiaoliang ZHANG, Hui QU, Tao JIANG, et al. Clinical study of Bazhen Decoction combined with decitabine and CAG chemotherapy in the treatment of elderly acute myeloid leukemia. [J]. Shanghai Journal of Traditional Chinese Medicine 55(4):55-59(2021)
DOI：

Xiaoliang ZHANG, Hui QU, Tao JIANG, et al. Clinical study of Bazhen Decoction combined with decitabine and CAG chemotherapy in the treatment of elderly acute myeloid leukemia. [J]. Shanghai Journal of Traditional Chinese Medicine 55(4):55-59(2021) DOI： 10.16305/j.1007-1334.2021.2010074.

摘要

目的,2,观察八珍汤联合地西他滨、CAG方案对老年急性髓系白血病（AML）的临床疗效。,方法,2,将64例老年AML患者随机分为对照组和治疗组，每组32例。对照组采用地西他滨、CAG方案化疗，治疗组在对照组治疗措施基础上加服八珍汤；两组均以28 d为1个疗程，共治疗2个疗程。观察临床疗效、化疗后重度骨髓抑制及不良反应的发生情况，比较中医证候积分的变化情况。,结果,2,①西医疾病疗效：治疗组总有效率为50.00%，对照组总有效率为46.88%；组间西医疾病疗效比较，差异无统计学意义（,P,>,0.05）。中医证候疗效：治疗组总有效率62.50%，对照组总有效率46.88%；组间中医证候疗效比较，差异有统计学意义（,P,<,0.05）。②治疗前后组内比较，治疗组骨痛、瘀斑、头晕、乏力、纳差、发热积分降低（,P,<,0.05），对照组仅骨痛、头晕、乏力、纳差积分降低（,P,<,0.05）；组间治疗后比较，治疗组瘀斑、头晕、乏力、纳差、发热积分低于对照组（,P,<,0.05）。③治疗组重度骨髓抑制（Ⅲ级）及心力衰竭、肺部感染、胃肠道不适发生率均低于对照组（,P,<,0.05）。,结论,2,八珍汤联合地西他滨、CAG方案治疗老年AML疗效满意，有助于改善化疗后患者的骨髓抑制程度及气血亏虚症状，并减少化疗不良反应的发生。

Abstract

Objective,2,To observe the clinical effect of Bazhen Decoction combined with decitabine and CAG chemotherapy in the treatment of elderly acute myeloid leukemia (AML).,Methods,2,Totally 64 elderly AML were randomly divided into control group (,n,=32) and treatment group (,n,=32). The control group was administered with decitabine and CAG chemotherapy, while the treatment group was additionally administered with Bazhen Decoction besides the treatment of the control group. Both groups were treated for 2 courses of treatment, and each course lasted 28 days. The clinical effect, the incidence of severe myelosuppression and adverse reactions after chemotherapy were observed, and the changes of TCM syndrome scores were compared.,Results,2,①The curative effect of AML: the total effective rate of the treatment group was 50.00%, and that of the control group was 46.88%. There was no significant difference in the curative effect of AML between groups (,P,>,0.05). The curative effect of TCM syndromes: the total effective rate of the treatment group was 62.50%, and that of the control group was 46.88%. The difference of TCM syndrome curative effect between groups was statistically significant (,P,<,0.05). ②According to the intra-group comparison before and after treatment, the scores of bone pain, ecchymosis, dizziness, fatigue, anorexia and fever in the treatment group decreased (,P,<,0.05), while only the scores of bone pain, dizziness, fatigue and anorexia in the control group decreased (,P,<,0.05); After treatment, the scores of ecchymosis, dizziness, fatigue, anorexia and fever in the treatment group were lower than those in the control group (,P,<,0.05). ③The incidences of severe myelosuppression (grade Ⅲ), heart failure, pulmonary infection and gastrointestinal discomfort in the treatment group were lower than those in the control group (,P,<,0.05).,Conclusion,2,Bazhen Decoction combined with decitabine and CAG chemotherapy regimen is effective in treating elderly AML as Bazhen Decoction is helpful to improve the myelosuppression and the symptoms of deficiency of qi and blood after chemotherapy, and reduce the incidence of adverse reactions of chemotherapy.

关键词

急性髓系白血病老年人八珍汤地西他滨CAG方案化疗骨髓抑制

Keywords

acute myeloid leukemiaelderlyBazhen DecoctiondecitabineCAG regimenchemotherapymyelosuppression

references

ESTEY E. AML in older patients: are we making progress[J]. Best Pract Res Clin Haematol, 2009, 22(4): 529-536.

NICOLAS E, RAMUS C, BERTHIER S, et al. Expression of S100A8in leukemic cells predicts poor survival in de novo AML pa-tients[J]. Leukemia, 2011, 25(1): 57-65.

李超. 诱导缓解化疗方案治疗老年急性髓系白血病的疗效及预后[J].中国老年学杂志，2013, 33(11): 2659-2660.

钱思轩，李建勇. 老年急性髓细胞白血病治疗现状与思考[J]. 临床血液学杂志，2014, 27(3): 363-367.

代兴斌，孙雪梅，姜鹏君，等. 升麻鳖甲汤加减方联合CAG方案治疗阴虚毒瘀型老年急性髓系白血病的临床研究[J]. 中国中西医结合杂志，2016, 36(2): 149-154.

中华医学会血液学分会白血病淋巴瘤学组. 成人急性髓系白血病（非急性早幼粒细胞白血病）中国诊疗指南（2017年版）[J]. 中华血液学杂志，2017, 38(3): 177-182.

国家中医药管理局. 22个专业95个病种中医诊疗方案[M]. 北京：中国中医药出版社，2010: 295.

沈悌，赵永强. 血液病诊断与治疗标准[M]. 北京：科学出版社，2018: 88.

MEDEIROS B C, SATRAM-HOANG S, HURST D, et al. Big data analysis of treatment patterns and outcomes among elderly acute myeloid leukemia apatients in the United States[J]. Ann Hematol, 2015, 94(7): 1127-1138.

BURNETT A K. The challenge of AML in older patients[J]. Mediterr J Hematol Infect Dis, 2013, 5(1): 2013038.

姜涛，万纯黔，陈姣，等. 老年急性髓系白血病临床及预后分析[J]. 四川医学，2018, 39(6): 669-673.

李丹丹. 老年急性髓系白血病给予CAG方案治疗的临床观察[J]. 中国医药指南，2019, 17(6): 59-60.

刘静. CAG方案治疗老年急性髓系白血病30例临床观察[J]. 中国现代医生，2012, 50(5): 120-121.

张冰，张东华. 老年急性髓细胞白血病的治疗策略与进展[J]. 医学综述，2011, 17(6): 883-886.

张鸣，刘卓刚.基因甲基化与肿瘤耐药的相关性[J].医学综述，2014, 20(14): 2553-2555.

NIETO M, DEMOLIS P, BEHANZIN E, et al. The european medicines agency review of decitabine(dacogen) for the treatment of adult patients with acute myeloid leukemia：summary of the scientific assessment of the committee for medicinal products for human use[J]. Oncologist, 2016, 21(6): 692-700.

MAMDANI H, SANTOS C D, KONIG H.Treatment of acute myeloid leukemia in elderly patients-A therapeutic dilemma[J]. J Am Me Dir Assoc, 2016, 17(7): 581-587.

刘静，李云，王晶，等. CAG方案联合地西他滨治疗老年急性髓系白血病的临床观察[J]. 中国现代医生，2019, 57(18): 84-86.

李章坤，赖应昌，李坤，等. 地西他滨联合减量CTG方案治疗中高危骨髓增生异常综合征和急性髓细胞白血病的临床应用[J]. 中国肿瘤临床与康复，2016, 23(9): 1095-1098.

谢春红，韦敏，刘琴，等. 地西他滨联合CAG方案治疗老年急性髓系白血病的Meta分析[J]. 检验医学与临床，2019, 16(22): 3284-3288.

黄振翘，梁冰，陈信义，等. 实用中医血液病学[M]. 上海：上海科学技术出版社，2005: 329.

中国中西医结合学会血液专业委员会. 老年急性髓系白血病（非急性早幼粒细胞白血病）中西医结合诊疗专家共识[J]. 中国中西医结合杂志，2019, 39(4): 405-411.

王建伟，王亚平，王莎莉，等. 人参总皂苷协同造血生长因子体外诱导CD34+造血干/祖细胞体外扩增与分化的作用[J]. 中国实验血液学杂志，2006, 14(5): 959-963.

唐斌，程绪菊，刘江，等. 人参皂苷药理作用研究进展[J]. 西南军医，2005, 7(3): 45-47.

曹道俊，黄霞，刘惠霞. 熟地多糖补血作用的临床与实验研究——附熟地多糖合康力龙治疗再生障碍性贫血疗效观察[J]. 辽宁中医杂志，2005(12): 1317-1318.

杜培凤，聂进红. 白术研究综述[J]. 齐鲁药事，2004, 23(9): 41-43.

张秀明. 茯苓药理作用研究概况[J]. 中药材，2001, 24(6): 446-449.

张雁，芮永军，糜菁熠，等. 当归多糖对放射损伤小鼠骨髓单个核细胞细胞周期及细胞凋亡的影响[J]. 重庆医科大学学报，2011, 36(8): 913-916.

孟慧玲. 当归多糖的药理学研究新进展[J]. 甘肃中医，2007, 20(1): 44-46.

周强，栗占国. 白芍总苷的药理作用及其在自身免疫性疾病中的应用[J]. 中国新药与临床杂志，2003, 22(11): 687.

李秋怡，干国平，刘焱文. 川芎的化学成分及药理研究进展[J]. 时珍国医国药，2006, 17(7): 1298-1299.

王艳萍，李文兰，范玉奇. 川芎嗪药理作用的研究进展[J]. 药品评价，2006, 3(2): 144-146.

田庆来，官月平，张波. 甘草有效成分的药理作用研究进展[J]. 天然产物研究与开发，2006, 18(1): 343-347.

贾磊，张跃强. 八珍汤加减对肺癌化疗后骨髓抑制的影响[J]. 北方药学，2018, 15(1): 53.

余莹，范丽丽，程健，等. 改良八珍汤治疗急性白血病化疗后骨髓抑制临床观察[J]. 中医药临床杂志，2017, 29(3): 377-380.

朱玲玲，朱晓光. 加味八珍汤对急性髓系白血病化疗后毒副反应的防治作用[J]. 广州中医药大学学报，2014, 31(4): 518-521.

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