再生方治疗骨髓增生异常综合征的临床疗效及细胞形态学观察

Observation and the morphological changes of myelodysplastic syndrome treated with Chinese herbs Zaishengfang

目的观察中药再生方治疗骨髓增生异常综合征(MDS)——难治性贫血、伴多系病态造血的难治性贫血的临床疗效及细胞形态学变化。方法MDS患者共65例,随机分为再生方组32例和司坦唑醇组33例。再生方组给予补肾中药再生方治疗,水煎服,日1剂;司坦唑醇组采用西药司坦唑醇,每日6～8mg口服。2组均治疗3个月以上进行疗效统计,并观察骨髓细胞形态学变化。结果再生方组基本缓解9例,部分缓解6例,进步10例,无效7例,总有效率78.1%;司坦唑醇组基本缓解1例,部分缓解3例,进步6例,无效20例,总有效率30.3%。再生方组总有效率显著高于司坦唑醇组(P<0.01)。细胞形态学观察发现,再生方组使MDS红系病态造血减轻,对粒系、巨核系细胞形态无明显影响;司坦唑醇组红系、粒系和巨核系细胞病态造血无改善。结论中药再生方治疗MDS疗效好,可改善MDS患者红系的病态造血。

Objective To study the clinical effect of Chinese herbs Zaishengfang on myeladysplastic syndrome - refractory anemia （RA） and Refractory cytopenia with multilineage dysplasia（RCMD） and observe the morphological changes after treatment, Methods 65 patients with MDS（ 10 RA and 55 RCMD ） were divided into two groups randomly：Zaishengfang group （ n = 32） and control group （ n = 33）. Patients in Zaishengfang group treated by a dose of Chinese herbs administered orally every day, and patients in control group treated by Androstanazole, 2mg, tid. The therapeutic course was three months in both groups. Morphological change of hone marrow smears was observed. The adverse events were recorded and reckoned transfusion of blood cell. Results The effective rate in Zaishengfang group was higher than that in the control group （78.1% vs. 30.3%, P 〈 0.01 ）. In the Zaishengfang group, 9 were relieved, 6 were markedly improved, 10 were improved, and 7 were ineffective. In the control group 1 were relived, 3 were markedly improved, 6 were improved, and 20 were ineffective. The count of transfusion of blood cell were fewer in the Zaishengfang group than in the control group, especially in transfusion of platelets （ P 〈 0.01 ）. In adverse events Zaishengfang group were few and mild than the control group （ P 〈 0. 01 ）. To observe the morphological of hone marrow smears find that the displasis of erythrocytic series were abated in the Zaishengfang group, but on change on granulocyte and megakaryocyte. No morphological changes of erythrocyte and granulocyte and megakaryocyte in the patients of treatment with androstanazole. Conclusion Chinese herbs Zaishengfang was effective and safe for MDS, and it can abate the displasis of erythrocytic series.