中西药物联合治疗急性髓系白血病48例

Treatment for 48 Cases of Acute Myeloid Leukemia by the Combination of Traditional Chinese and Western Medicine

目的:观察益气健脾补肾汤联合阿柔比星、阿糖胞苷诱导缓解化疗方案治疗急性髓系白血病(AML)的临床疗效。方法:将96例患者随机分为对照组和观察组各48例,2组均给予阿柔比星联合阿糖胞苷诱导缓解化疗方案。观察组在此基础上给予益气健脾补肾汤,化疗期间,1剂/d,水煎分服。结果:完全缓解率观察组为50.0%,对照组为25.0%,2组比较差异显著(P<0.05)。总有效率观察组为79.2%,对照组为45.8%,2组比较差异显著(P<0.05)。出血、感染、胃肠道反应、骨髓抑制、肝功能异常等不良反应发生率观察组显著低于对照组(P<0.05)。6、12、18个月时复发率对照组为25.0%、54.2%、58.3%,观察组为16.7%、20.8%、20.8%。2组比较差异具有统计学意义(P<0.05)。结论:益气健脾补肾汤联合阿柔比星、阿糖胞苷诱导缓解化疗方案治疗AML疗效确切,复发率低,可以有效降低化疗毒性反应。

Objective：To observe curative effects of tonifying Qi, spleen and kidney decoction, aclarubicin and cytosine arabinoside induction remission chemotherapy in treating acute myeloid leukemia （AML）. Methods：All 96 patients were randomized into the control group and the observation group, both groups were given with aclarubicin and cytosine arabinoside induction remission chemotherapy, the observation group took tonifying Qi, spleen and kid-ney decoction orally, one dose each day, during the period of chemotherapy, water decocted and taken twice. Re-sults：Complete remission rate of the observation group was 50.0%, higher than 25.0%of the control group with re-markable difference （P〈0.05）. Total effective rate of the observation group was 79.2%, superior to 45.8%of the control group with notable difference （P〈0.05）. The observation group was obvisouly lower than the control group in the incidence rate of adverse reaction such as hemorrhage, infection, gastrointestinal reaction, arrest of bone mar-row, abnormal liver function and others （P〈0.05）. Relapse rates at the 6th, 12th and 18th month in the control group were 25.0%, 54.2%and 58.3%respectively, higher than 16.7%, 20.8%and 20.8%of the observation group, the dif-ference indicated statistical meaning （P〈0.05）. Conclusion：Tonifying Qi, spleen and kidney decoction, aclarubicin and cytosine arabinoside induction remission chemotherapy could obtain definite effects in treating AML with low relapse rate, the therapy could effectively decrease the toxicity of chemotherapy.