益神颗粒治疗化疗后白细胞减少症临床观察

目的:观察并评价益神颗粒治疗化疗后白细胞减少症的临床疗效。方法:选择恶性肿瘤化疗后出现白细胞减少症,且辨证为心脾两虚的患者,随机分为治疗组30例与对照组32例。治疗组予益神颗粒1袋,1d3次,口服;对照组予鲨肝醇片40mg,1d3次口服,疗程均为2月。观察治疗前后两组白细胞计数及中医证候积分的变化,并评价两组疾病疗效及中医证候疗效。结果:治疗组的疾病总有效率达到80.00%,对照组则为78.13%,无统计学差异(P>0.05);白细胞计数改善情况两组相当,无统计学意义(P>0.05);治疗组中医证候疗效的总有效率为86.67%,对照组为71.88%,具有统计学意义(P<0.05),证候积分的改善情况,治疗组明显优于对照组,具有统计学意义(P<0.01)。结论:益神颗粒治疗化疗后白细胞减少症(心脾两虚型)具有良好之临床效果。

八珍汤治疗恶性肿瘤化疗后白细胞减少症临床研究

目的:评价八珍汤治疗恶性肿瘤化疗后白细胞减少症的临床疗效及安全性。方法:将60例恶性肿瘤放疗后继发性白细胞减少症、中医辨证为气血两虚的患者随机分为治疗组30例和对照组30例。对照组予以地榆升白片100mg,3次/d;治疗组予以口服八珍汤汤剂400ml,200ml口服,2次/d。两组患者治疗两周为1个疗程,均服药3个疗程。比较两组治疗前后的白细胞数量、临床疗效以及不良反应发生率。结果:治疗后,两组患者白细胞数量较治疗前均明显上升(P<0.05),且治疗组白细胞数量明显高于对照组(P<0.05)。治疗组总有效率为86.67%,明显高于对照组73.33%(P<0.05)。两组患者均未见明显不良反应。结论:同地榆升白片相比,八珍汤用于治疗恶性肿瘤化疗后白细胞减少症的疗效更佳,且未见明显不良反应。

Total embolization of the main splenic artery as a supplemental treatment modality for hypersplenism

AIM:To study the safety and feasibility of total embolization of the main splenic artery as a supplemental treatment modality for hypersplenism with thrombocytopenia or leukocytopenia accompanying liver cirrhosis.METHODS:Fifteen consecutive patients with hypersplenism due to cirrhosis were enrolled in this study from January 2006 to June 2010.All patients underwent total embolization of the main splenic artery.Clinical symptoms,white blood cell(WBC) and platelet(PLT) counts,splenic volume,and complications of the patients were recorded.The patients were followed up for 1 and 6 mo,and 1,2,3 years,respectively,after operation.RESULTS:Total embolization of the main splenic artery was technically successful in all patients.Minor complications occurred in 13 patients after the procedure,but no major complications were found.The WBC andPLT counts were significantly higher and the residual splenic volume was significantly lower 1 and 6 mo,and 1,2,3 years after the procedure than before the procedure(P < 0.01).Moreover,the residual splenic volume increased very slowly with the time after embolization.All patients were alive during the follow-up period.CONCLUSION:Total embolization of the main splenic artery is a safe and feasible procedure and may serve as a supplemental treatment modality for hypersplenism with thrombocytopenia or leukocytopenia accompanying liver cirrhosis.

Clinical Study of Combining Chemotherapy of Oxaliplatin or 5-Fluorouracil/Leucovorin with Hydroxycamptothecine for Advanced Colorectal Cancer

OBJECTIVE To estimate effects, survival rate after the short-time efficacy, side the treatment of combining chemotherapy of oxaliplatin or 5-fluorouracil/leucovorin with hydroxycamptothecine （HCPT） for the patients with advanced colorectal cancer. METHODS From January 2002 to November 2005, 59 patients with advanced colorectal cancer confirmed by pathology were enrolled into this study in the department of medical oncology, in the Sixth People＇s Hospital of Shanghai Jiaotong University, Shanghai. Patients＇ characteristics in two groups were similarly confirmed by statistic. All 37 patients in OH group received oxalip21atin （130 mg/m^2 d1） plus hydroxycamptothecine （6 mg/m d1-4）, and all 22 patients in the HLF group received hydroxycamptothecine （6 mg/m^2 d1-4） plus leucovorin （300 mg d1-5） and 5-fluorouracil （0.375 g/m^2 d1-5）. The regimens in both groups were 21-day cycle that was repeated three weeks. The side effects were evaluated. The efficacy was estimated after two cycles of chemotherapy for each patient. RESULTS The efficacy of the treatment in the OH group with 37 patients and in the HLF group with 22 patients was estimated. The overall response rate （CR ＋ PR） was 32.4% in the OH group and 22.7% in the HLF group. There was no complete response （CR） and there was no statistical significantly difference （%2= 0.876, P = 0.704） in two groups. The 1-year survival rate was 30.98% in the OH group and 15.02% in the HLF group, and it had no significant difference between the two groups. The median PSF and OS were 5.83 months and 11.17 months in the OH group vs. 7.40 months and 10.48 months in the HLF group, and it had no significant differences between the two groups （P 〉 0.05）. The major side effects of grade III and IV in the two groups were myelosuppression and gastrointestinal reactions. The statistically significant difference in side effects appeared in leukopenia （χ^2= 17.173, P = 0.001）, nausea/vomiting （χ^2= 6.426, P = 0.039）, diarrhea （χ^2= 16.245, P = 0.000） and peripheral neuropathy. CONCLUSION The efficacy was almost equal between the OH and the HLF groups, and the two regimens can be used as the second-line treatments for the patients with colorectal cancer. Leucopenia, nausea, diarrhea and peripheral neuropathy appeared more in OH group, and anemia and thrombocytopenia were almost equal between the OH and the HLF groups.

Calf spleen extract alleviates cyclophosphamide-induced leucopenia in mice and inhibits the glycolysis of HL60 cells

Calf spleen extract(CSE) has been clinically used as an adjuvant agent in malignant tumor therapy.It can improve the physical status of patients.However,its mechanism of action remains relatively unclear.In this study,we investigated the effect of CSE on leucopenia in mice and on promyelocytic leukemia cells(HL60).CSE in 10 mL/kg(2.5 mg bioactive polypeptides and 190μg ribose/mL) significantly increased leukocyte numbers in leucopenia mice.The effect on neutrophil numbers,among all leukocytes,was the most evident.CSE stimulated the proliferation of bone marrow cells in vitro and decreased the GM-CSF level in serum.In addition,CSE significantly reduced the viability of HL60 cells,decreased the production of lactate and adenosine triphosphate(ATP) of these cells.CSE induced the apoptosis and S-phase arrest in HL60 cells.In conclusion,CSE can enhance leukocyte numbers,which may be attributed to its direct stimulatory effect on bone marrow cells.CSE is an inhibitor of promyelocytic leukemia cell viability,which may be attributed to the induction of the apoptosis,the arrest of cell cycle and the inhibition of the glycolysis of cells.

Acupoint Injection plus Moxibustion on Post-chemotherapy Leukopenia

Objective： to investigate the effect moxibustion on white blood cell amount and of Radi.r Astragali （ 黄芪 ） Injection and cellular immunity in patients with postchemotherapy leukopenia. Methods： eighty-six cases of post chemotherpy leucopenia were allocated into group of acupoint injection with Radix Astragali （黄芪） plus mild moxibustion with moxa stick（treatment group） and group of westerm medicine orally took（control group）, and the clinical symptoms, white blood cell amount, and the change of CD3^＋ , CD4^＋ and CD8^＋ before and after the treatment were observed. Results. acupoint injection with Radicc Astragali（黄芪） plus mild moxibustion with moxa stick could enhance the white blood cell amount more markedly than western medicine. The former could increase the contents of CD3^＋ and CD2^＋, and promote the ratio of CD4^＋ /CD^＋ of the patients with tumor, meanwhile, improve the general weak, and there is a significant different between the two groups（P〈 0.01）.

Relationship etween Electroacupuncture and Spleen Function on Leukocyte

Objective： To explore the underlying mechanism by which acupuncture regulates the peripheral leukocyte count and observe the relationship between the effects of electroacupuncture （EA） and the spleen ultrastructure in leukopenia. Methods： Leukopenia models of rabbits were established by injecting cyclophosphamide （CY） into rabbits＇ ear vein, and then the rabbits were treated with acupuncture. The peripheral leukocyte count and classification were measured daily. At last, after the animals were anesthesized, the abdominal cavity was opened, and a piece of spleen tissue was cut. The diameter of splenic sinusoid basal lamina eyehole was measured under electric microscope. Results： The peripheral blood leukocyte count in the EA group increased significantly with shift to fight of the granulocyte nuclei compared with model control group （P〈0.01）. Moreover, the calibers of splenic sinusoid basal lamina eyehole in the EA group were larger than those in the model control group （P〈0.05）. Conclusion： Acupuncture can enhance the peripheral leukocyte count by promoting spleen activity in the early phase of leukopenia.

Regulatory Effect of Acupuncture and Moxibustion on the Hematopoiesis of Leukopenia Model in Rats

Objective. To investigate the effect of acupuncture or moxibustion at acupoint Geshu （BL 17） on raising leukocyte and promoting marrow proliferation. Methods.. Wister rats were selected to establish the leukopenia and immuno-suppression model by intraperitoneal injection of cytoxan （CTX）. After they were grouped and treated, leukocyte and marrow karyocyte were counted in different phases to evaluate the effect of acupuncture or moxibustion at acupoint Geshu （BL 17） on raising leukocyte and promoting marrow hematopoiesis. Results. Acupuncture or moxibustion at acupoint Geshu （BL 17） and routine western medicine could all significantly raise leukocyte and increase marrow karyocyte. The curative effect was better in moxibustion group than in acupuncture group and in routine western medicine group （P〈 0.05）. Conclusion. Moxibustion at acupoint Geshu （BL 17） can markedly raise peripheral blood leukocyte and marrow karyocyte of the leucopenia model in rats.