青黄散联合补肾健脾方及雄激素治疗伴原始细胞增多骨髓增生异常综合征疗效回顾性分析

Retrospective Analysis on the Effectiveness of Qinghuang Powder Combined with Bushen Jianpi Formula and Androgens for Patients with Myelodysplastic Syndrome of Refractory Anemia with Excess of Blasts

目的分析青黄散联合补肾健脾方及雄激素治疗伴原始细胞增多的骨髓增生异常综合征(MDS-RAEB)的疗效及安全性。方法回顾分析124例首次以青黄散联合补肾健脾方及雄激素治疗的MDS-RAEB患者资料,比较治疗前后外周血白细胞(WBC)计数、中性粒细胞(ANC)计数、血红蛋白(HGB)、血小板(PLT)计数、红细胞输注依赖比例及骨髓原始细胞计数的变化,评估患者的治疗反应,并记录治疗期间发生的不良反应及处理,统计治疗未进展患者外周血WBC、ANC、HGB、PLT计数随治疗时间的变化。结果青黄散联合补肾健脾方及雄激素治疗MDS-RAEB 6个月后总改善率达29.0%,总有效率达69.4%,不良反应发生率8.1%,对RAEB-Ⅰ与RAEB-Ⅱ的临床治疗疗效相当(P>0.05);治疗后未进展患者外周血WBC、ANC、HGB和PLT计数均升高(P<0.05), HGB在治疗期间持续升高(P<0.01)。结论青黄散联合补肾健脾方及雄激素治疗MDS-RAEB安全有效,可提高患者外周血WBC、ANC、HGB和PLT计数,对外周血HGB的改善更突出且呈持续性。

Objective To evaluate the effectiveness and safety of Qinghuang Powder(QHP) combined with Bushen Jianpi Formula(BJF) and androgens to myelodysplastic syndrome of refractory anemia with excess of blasts(MDS-RAEB). Methods We retrospectivly analyzed 124 MDS-RAEB patients who were treated with QHP combined with BJF and androgens for the first time, the peripheral blood white blood cells(WBC),neutrohils(ANC),hemoglobin(HGB),platelets(PLT),erythrocyte infusion dependency ratio and primitive bone marrow cells were chosen as the main evaluation indexes to analyze the treatment effect. Adverse reactions and corresponding treatment measures during treatment were recorded. The changes of the peripheral blood cells count of patients without progress disease(PD)were analized. Results The improvement rate of QHP combined with BJF and androgens to MDS-RAEB for 6 months is 29.0% and overall response rate is 69.4%,the incidence of adverse reaction was 8.1%. The effectiveness of QHP to RAEB-Ⅰ is similar to RAEB-Ⅱ(P>0.05). The number of peripheral blood cells of patients without PD all increased after treatment(P<0.05). During the treatment, the number of HGB remained increasing(P<0.01). Conclusions QHP combined with BJF and androgens may be an appropriate treatment option for MDS-RAEB patients.The protocol can improve the numeber of peripheral blood cells,especialally the number of HGB.The improvement of HGB counts was sustained during treatment.