活血逐瘀方联合化疗治疗多发性骨髓瘤临床疗效及对机体免疫功能的影响

Clinical Observation of Huoxue Zhuyu Decoction Combined with Chemotherapy in Treatment of Multiple Myeloma and Its Effect on Immune Function

目的观察活血逐瘀方联合化疗治疗多发性骨髓瘤的临床效果及对机体免疫功能的影响。方法选取80例多发性骨髓瘤患者,随机分为两组,对照组患者给予硼替佐米、地塞米松治疗,观察组患者采用活血逐瘀方联合化疗治疗,两组均以21 d为1个治疗周期,化疗2个周期。比较治疗前后两组患者的临床指标(中性粒细胞、血小板计数、血红蛋白、M蛋白和β2微球蛋白)、T细胞的亚群(CD3^+、CD4^+、CD8^+、CD4^+/CD8^+)、中医证候进行积分、NRS评分、生活质量评价及安全性评价。结果观察组患者的ORR及DCR均明显高于对照组;两组比较有显著差异(P<0.05)。治疗后观察组患者的中性粒细胞、血小板计数、M蛋白和β2微球蛋白的水平明显降低(P<0.05),血红蛋白的水平显著升高(P<0.05),并且所有指标均显著优于对照组(P<0.05)。治疗后观察组患者的中性粒细胞、血小板计数、M蛋白和β2微球蛋白的水平明显降低(P<0.05),血红蛋白的水平显著升高(P<0.05),并且所有指标均显著优于对照组(P<0.05)。观察组患者治疗后腰膝酸软,畏寒肢冷,脉络瘀血,皮下瘀斑,肢体麻木,神疲乏力等证候评分及NRS评分均显著降低(P<0.05),并且各项评分均明显优于对照组(P<0.05)。治疗后观察组患者的KPS评分明显高于对照组,差异有统计学意义(P<0.05)。观察组患者骨髓抑制、脱发、肝脏功能异常、肾脏功能异常、蛋白尿、周围神经毒性等不良反应发生率均低于对照组(P<0.05)。结论活血逐瘀方联合化疗可以明显提高多发性骨髓瘤患者免疫功能及生活质量,减少不良反应,临床疗效显著。

Objective To observe the clinical effect of Huoxue Zhuyu Decoction combined with chemotherapy on multiple myeloma and its influence on immune function.Methods Eighty patients with multiple myeloma were randomly divided into two groups.The patients in the control group were treated with bortezomib and dexamethasone.Those in the observation group were treated with Huoxue Zhuyu Decoction combined with chemotherapy.The two groups had 21 days as a treatment cycle and 2 cycles of chemotherapy.The clinical indexes(neutrophil,platelet count,hemoglobin,M protein andβ2 microglobulin),T cell subsets(CD3^+,CD4^+,CD8^+,CD4^+/CD8^+),TCM syndrome scores,NRS scores,quality of life and safety evaluation were compared between the two groups before and after treatment.Results The ORR and DCR in the observation group were significantly higher than those in the control group,and there was a significant difference between the two groups(P<0.05).After treatment,the levels of neutrophils,platelet count,M protein andβ2 microglobulin in the observation group decreased significantly(P<0.05),while the levels of hemoglobin increased significantly(P<0.05),and all the indexes were significantly better than those in the control group(P<0.05).After treatment,the levels of neutrophils,platelet count,M protein andβ2 microglobulin in the observation group decreased significantly(P<0.05),while the levels of hemoglobin increased significantly(P<0.05),and all the indexes were significantly better than those in the control group(P<0.05).After treatment,the scores of lumbar and knee weakness,chills,cold limbs,blood stasis,subcutaneous ecchymosis,limb numbness,mental fatigue and NRS scores in the observation group were significantly reduced(P<0.05),and the scores were significantly lower than those in the control group(P<0.05).After treatment,the KPS score of the observation group was significantly higher than that of the control group(P<0.05).The incidence of adverse reactions such as bone marrow suppression,alopecia,liver dysfunction,kidney dysfunction,proteinuria and peripheral neurotoxicity in the observation group was lower than that in the control group(P<0.05).Conclusion Huoxue Zhuyu Decoction combined with chemotherapy can significantly improve the immune function and quality of life of multiple myeloma,reduce adverse reactions,and have a significant clinical effect.