126例原发性骨髓增生异常综合征患者中医证候及用药分析

Analysis of traditional Chinese medicine syndromes and medication in 126 primary myelodyplastic syndrome patients

目的:通过建立骨髓增生异常综合征(MDS)病例数据记录表,收集近10年在北京中医药大学东直门医院血液肿瘤科明确诊断为原发性MDS的126例住院患者的第一次住院临床资料,总结该患者群体的中医证候特点、中药用药规律及特点等,为MDS的中医药治疗提供血液学参考依据,更好的指导临床对于MDS的诊治,验证益髓颗粒的组成是否符合临床证候特点。方法:通过回顾性分析2006年1月1日至2016年9月30日在北京中医药大学东直门医院血液肿瘤科明确诊断为原发性MDS的住院患者的临床资料,建立统一的病例数据记录表,采用SPSS20.0对患者的中医症状、证候、中药用药情况等进行统计分析。结果:(1)MDS患者单项证候出现频次以气虚证(67.46%)最高;(2)临床应用中药治疗MDS,以补血药、益气药、养阴药、活血药的应用所占比例较大;(3)临床中常以养血益气滋阴为指导原则,应用中药并随证加减治疗MDS。结论:MDS主要以气血虚损为本,以益气养阴活血为法组方的益髓颗粒在临床上具有有很大应用价值。

Objective： Through the establishment of myelodyplastic syndrome（MDS） case report form, we collected the clinical information of hospitalized MDS patients when they were included in the in-patient department of hematology and oncology in Dongzhimen Hospital Affiliated with Beijing University of Chinese Medicine for the first time. The characteristics of TCM syndromes as well as the traditional Chinese medicine would be summarized in order to provide reference for the treatment of MDS using traditional Chinese medicine, and better guidance for clinical diagnosis and treatment of MDS would be provided. Methods： In this study, a retrospective clinical case study method was used to establish a unified information collection form for patients with MDS, from January 1 st, 2006 to September 30 th, 2016 in the Department of Hematology at Dongzhimen Hospital affiliated with Beijing University of Chinese Medicine using SPSS 20.0 software for statistical analysis. Results：（1）The most occurrence of single TCM syndrome of primary MDS patients was qi deficiency syndrome.（2）Among the clinical application of Chinese medicine, those with the function of blood-nourishing, qi reinforcing, yin tonifying and blood-circulation activating were the major categories.（3）Treatment of MDS often with the guiding principles of nourishing blood, supplementing qi and nourishing yin in clinical. Conclusion： Qi deficiency is the most common syndrome for MDS patients. Yisui Granules have the action to tonify qi, nourish blood and activate blood circulation, and it is of great importance in clinical MDS treatment.