中西医结合治疗促红细胞生成素拮抗的肿瘤相关性贫血临床研究

Clinical Study on Integrated Chinese and Western Medicine for Cancer Related Anemia of Erythropoietin Antagonism

目的：观察中西医结合治疗促红细胞生成素（EPO）拮抗的肿瘤相关性贫血（CRA）患者的效果和安全性。方法：选取60例EPO拮抗的CRA患者作为研究对象,随机分为研究组和对照组各30例,研究组采用健脾益肾、气血双补法联合常规对症治疗,对照组以常规对症治疗,2组均治疗8周。观察2组患者治疗期间血红蛋白（Hb）、T淋巴细胞亚群（CD3,CD4,CD8,CD4/CD8）、自然杀伤（NK）细胞的变化情况以及不良反应。结果：2组Hb水平在治疗前、治疗7天以及治疗14天时比较,差异均无统计学意义（P〉0.05）,而研究组治疗21、28、35、42、49以及56天的Hb水平均较对照组增高,差异均有统计学意义（P〈0.05）。治疗后,研究组CD3、CD4、CD8和NK细胞水平均较治疗前升高,CD4/CD8值较治疗前降低,差异均有统计学意义（P〈0.05）;2组各指标值比较,差异均有统计学意义（P〈0.05）。研究组各项Ⅰ-Ⅱ度和Ⅲ-Ⅳ度不良反应的发生率均较对照组有所减少或一致,差异并不具有统计学意义（P〉0.05）。结论：中西医结合治疗能有效提高EPO拮抗的CRA患者的Hb水平,改善机体免疫功能,并对减少治疗过程中不良反应的发生具有一定的作用。

Objective： To observe the effect and safety of integrated Chinese and western medicine for patients with cancer related anemia（CRA） of Erythropoietin（EPO） antagonism. Methods： Selected 60 cases of patients with CRA of EPO antagonism as research objects, and divided into the research group and the control group, 30 cases in each group. The research group was given the therapy of strengthening spleen and nourishing kidney and tonifying qi-blood combined with Ferrous Fumarate granules, meanwhile the control group was given therapy of Ferrous Fumarate granules. The patients in both groups were all treated for 8 weeks. Compared level changes of hemoglobin （Hb）, subpopulations of T lymphocytes （CD3, CD4, CD8, CD4/CD8） and Natural killer（NK） cells, and adverse response during treatment in two groups. Results： Compared Hb levels before therapy, 7 days and 14 days after therapy between the two groups, there were no statistical significance（P〉0.05）, while 21 days, 28, 35, 42, 49 and 56 days after treatment, Hb levels were increased obviously in the research group, the differences between the two groups being statistically significant（P〈0.05）. After treatment, levels of CD3, CD4, CD8 and NK cells in the research group were increased, CD4/CD8 level was decreased（P〈 0.05 compared with before treatment）. Comparing levels of CD3, CD4, CD8, CD4/CD8 and NK cells between the two groups, the differences were significant（P〈0.05）. Ⅰ-Ⅱ and Ⅲ-Ⅳ adverse reaction rates in the research group were all lower than those in the control group, but there being no statistical significance（P〉 0.05）. Conclusion. Integrated Chinese and Western medicines not only can increase Hb levels of patients with CRA of EPO antagonism, improve body immunologic function, but also have a certain effect on reduce adverse reaction rate during treatment.