首页|老年急性髓系白血病患者采用升麻鳖甲汤、地西他滨联合阿糖胞苷+阿克拉霉素+粒细胞集落刺激因子的化疗方案的临床疗效比较研究

老年急性髓系白血病患者采用升麻鳖甲汤、地西他滨联合阿糖胞苷+阿克拉霉素+粒细胞集落刺激因子的化疗方案的临床疗效比较研究

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目的 比较老年急性髓系白血病(Acute Myeloid Leukemia,AML)患者采用升麻鳖甲汤、地西他滨并联合CAG化疗方案的临床疗效,从而为老年急性髓系白血病患者的治疗提供相关参考.方法 选取2015年4月~2016年5月于天津医科大学代谢病医院确诊的120名老年急性髓系白血病患者作为研究对象,随机分为中药组(40例)、西药组(40例)及对照组(40例).中药组患者采用升麻鳖甲汤联合阿糖胞苷(Ara-c)+阿克拉霉素(ACR)+粒细胞集落刺激因子(G-CSF)的CAG化疗方案治疗;西药组采用地西他滨联合CAG化疗方案进行治疗;对照组采用CAG化疗方案进行治疗.收集2组患者临床治疗资料后,对2组患者治疗前后疗效情况、ECOG体力评分、不良反应状况进行对比.结果 与对照组相比,中药组与西药组的完全缓解率(Complete Remission CR)(χ2=10.131,8.020;P=0.001,0.005)与总体有效率(Objective Response Rate, ORR)(χ2=14.245,8.791;P=0.000,0.003)率均高于对照组.治疗失败(Non-Remission, NR)率均低于对照组(χ2=14.245,8.791;P=0.000,0.397);中药组的CR、部分缓解(Partial Remission, PR)及ORR率高于西药组,NR率低于西药组,但差异不具有统计学意义;与对照组患者相比,中药组与西药组患者的ECOG体力评分均降低(t=5.125,3.427;P=0.000,0.000).2组患者在治疗结束后不良反应的比较中,中药组的肺部感染、发热、血小板减少、恶心呕吐、腹泻、肝脏损伤的不良反应概率低于对照组,且差异具有统计学意义(t=10.286, 5.556, 15.126, 4.800, 7.207, 21.344;P=0.001, 0.018, 0.000,0.028,0.007,0.000);西药组的肺部感染、发热及恶心呕吐概率高于对照组(t=11.782,8.456,4.036;P=0.000,0.004,0.045),其余的低于对照组,差异具有统计学意义(P<0.05);中药组的不良反应概率低于西药组不良反应概率,且差异具有统计学意义(P<0.05).结论 升麻鳖甲汤联合CAG化疗方案对于老年AML患者的治疗效果优于地西他滨联合CAG化疗方案.
Elderly patients with acute myeloid leukemia comparative study on the clinical curative effect of Cimicifuga Biejia decoction, decitabine combined with Ara-c+ ACR+ G-CSF chemotherapy
Objective To compare the clinical efficacy of shenmabiejia and decitabine combined with CAG chemotherapy regimens in elderly patients with acute myeloid leukemia, so as to provide suggestions for the treatment of elderly patients with acute myeloid leukemia.Methods120 elderly patients with acute myeloid leukemia were randomly divided into Chinese medicine group (40 cases) and Western medicine group (40 cases) and control group (40 cases).The traditional Chinese medicine group were treated with shenmabiejia combined with CAG chemotherapy regimens;the western medicine group with decitabine combined with CAG chemotherapy regimens;the control group received CAG therapy only.Clinical data, effect, ECOG score and adverse reactions were collected.ResultsCompared with control group, CR (χ2=10.131,8.020, P=0.001,0.005) and ORR (χ2=14.245,8.791, P=0.000,0.003) of Chinese medicine group and Western medicine group were higher, NR were lower than those in the control group(χ2=14.245,8.791, P=0.000,0.397).Compared with the control group, ECOG physical scores of Chinese medicine group and Western medicine group were lower (t=5.125,3.427, P=0.000,0.000).The incidence of group, pulmonary infection, fever, thrombocytopenia, nausea and vomiting, diarrhea, liver injury of traditional Chinese medicine was lower than in the control group (t=10.286,5.556,15.126,4.800,7.207,21.344, P=0.001,0.018,0.000,0.028,0.007,0.000).The incidence of pulmonary infection, fever and nausea and vomiting the probability in Western medicine group is higher than that of control group (t=11.782,8.456,4.036, P=0.000,0.004,0.045).The probability of adverse reaction of traditional Chinese medicine is lower than that of western medicine group.ConclusionShenmabiejia combined with CAG chemotherapy is superior to docetaxel combined with CAG chemotherapy for elderly patients with AML.

acute myeloid leukemiaelderly patientscimicifuga Biejia decoctiondecitabine

周瑾、郭连宇、刘照胜

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天津医科大学代谢病医院药剂科,天津300050

天津医科大学药学院,天津300070

急性髓系白血病 老年患者 升麻鳖甲汤 地西他滨

2017

10.3969/j.issn.1005-1678.2017.05.061

中国生化药物杂志
南京生物化学制药研究所,全国生化制药情报中心站,中国生化制药工业协会,中国药品生物制品检定所

中国生化药物杂志

ISSN：1005-1678
年,卷(期)：2017.(5)
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