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

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

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、补肾健睥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。

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 O, 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.