十星丹联合西药治疗中低危骨髓增生异常综合征的临床观察

Clinical Observation of Shixing Pills Combined with Western Medicine for Treatment of Middle- and Low-risk Myelodysplastic Syndrome

【目的】观察十星丹联合常规西药支持治疗对中低危骨髓增生异常综合征(myelodysplastic syndrome,MDS)的临床治疗效果。【方法】18例中低危MDS患者采用十星丹等中药并联合西药常规支持治疗,观察比较治疗前后外周血细胞、骨髓病态造血分析以及输血需求频次等指标的变化情况。【结果】18例患者中,达到缓解12例,总缓解率(完全缓解+部分缓解)为66.7%,血液学改善4例,无效2例,总反应率为88.89%。治疗后,外周血白细胞、血红蛋白均较治疗前显著升高(P<0.05),病态造血情况也较治疗前明显改善(P<0.05),输血依赖或输血频繁患者较治疗前明显减少(P<0.05),血清铁蛋白、乳酸脱氢酶较治疗前明显下降(P<0.05)。【结论】十星丹等中药结合西医常规治疗对中低危MDS的总反应率良好,患者血液细胞有不同程度提高,骨髓造血改善,明显减少输血依赖,并无1例转化为白血症病,有利于患者生存质量的提高。延长治疗观察时间有可能进一步提高缓解率,值得深入研究和探讨。

Objective To observe the therapeutic effect of Shixing pills combined western medicine for the treatment of middle- and low-risk myelodysplastic syndrome （MDS） . Methods Eighteen middle- and low-risk MDS patients were treated with Shixing pills combined with conventional western medical supportive treatment. The peripheral blood cells, myeloid dyshaematopoiesis, and blood transfusion frequency were compared before and after treatment. Results Of the 18 patients, 12 were relieved, and the rate of complete relief and partial relief was 66.7%. The hemogram was improved in 4 patients, but was ineffective in 2 patients, the total reaction rate being 88.89%. After treatment, the peripheral white blood cell count and hemoglobin content were improved in all of the patients （P〈0.05 compared with those before treatment）. Meanwhile, the myeloid dyshaematopoiesis and blood transfusion dependence were relieved, blood transfusion frequency was reduced, and the serum levels of ferritin and lactate dehydrogenase were decreased （P〈0.05）. None of the patients developed into leukemia. Conclusion Shixing pills combined with western medicine shows good effect on improving peripheral blood cells, bone marrow hemopoiesis and blood transfusion dependence during the treatment of middle- and low-risk myelodysplastic syndrome, which is helpful for enhancing the quality of life of the patients. And further long-term clinical observation and mechanism research will be expected.