参芪仙补汤联合西药治疗骨髓增生异常综合征难治性贫血30例临床观察

Observation of Shenqixianbu decoction combined with western medicine on the treatment of refractory anemia with myelodyplastic syndrome

目的观察参芪仙补汤联合西药治疗骨髓增生异常综合征难治性贫血临床疗效。方法将60例骨髓增生异常综合征难治性贫血患者随机分为2组。治疗组30例予参芪仙补汤联合西药治疗;对照组30例采用单纯西药治疗。2组均3个月为1个疗程,1个疗程后判定疗效,并观察外周血象、中医证候积分、T淋巴细胞亚群等指标的变化。结果治疗组总有效率86.7%,对照组为56.7%,治疗组疗效优于对照组(P<0.05)。治疗组治疗后白细胞计数(WBC)、血红蛋白(Hgb)及血小板计数(PLT)均不同程度升高(P<0.05),对照组治疗后仅Hgb升高(P<0.05),治疗组治疗后WBC、Hgb及PLT高于对照组(P<0.05)。2组治疗后中医证候积分均下降(P<0.05),治疗组下降优于对照组(P<0.05)。治疗组治疗后CD4、CD4/CD8均上升(P<0.05),CD8数值下降(P<0.05);2组治疗后CD4、CD4/CD8比较差异均有统计学意义(P<0.05)。结论参芪仙补汤联合西药治疗骨髓增生异常综合征难治性贫血疗效确切,机制可能与调节机体免疫功能,促进骨髓造血,改善骨髓无效造血有关。

Objective To observe the curative effect of Shenqixianbu decoction combined with western medi -cine on refractory anemia with myelodyplastic syndrome .Methods 60 patients with refractory anemia with myelody-plastic syndrome were randomly divided into two groups .30 cases in treatment group were treated by Shenqixianbu de-coction combined with western medicine .30 cases in control group were treated by only western medicine .The course was three months in two groups .The therapeutic effect was evaluated after a course .The change of peripheral blood , traditional Chinese medicine syndrome score ,T lymphocyte subsets and other indicators were observed .Results The total effective rate in treatment group （86.7%） was superior to that in control group （56.7%,P〈0.05）.WBC,Hgb and PLT after treatment were increased in treatment group （P〈0.05）,only Hgb was increased in control group （P〈0.05）.The levels of WBC,Hgb and PLT in treatment group were higher than those in control group （P〈0.05）.Tra-ditional Chinese medicine syndrome score after treatment was decreased in two groups （P〈0.05）.The decrease in treatment group was superior to that in control group （P〈0.05）.There was significant difference between two groups on CD4 and CD4/CD8 after treatment （P〈0.05）.Conclusion Shenqixianbu decoction combined with western medicine on refractory anemia with myelodyplastic syndrome has definite effect ,its mechanism maybe related to regu-lating immune function ,promoting bone marrow ,improving bone ineffective hematopoiesis .