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青黄散为主治疗骨髓增生异常综合征的临床观察。

Clinical observation of the treatment of myelodysplastic syndrome mainly with Qinghuang Powder.

机构信息

Department of Hematology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing 100091, China.

出版信息

Chin J Integr Med. 2011 Nov;17(11):834-9. doi: 10.1007/s11655-011-0894-9. Epub 2011 Nov 6.

Abstract

OBJECTIVE

To observe the clinical effectiveness of Qinghuang Powder (QHP) combined with Bupi Yishen Decoction (, BPYS) in treating myelodysplastic syndrome (MDS), and its relationship with France, America, and Britain (FAB) type, international prognosis scaling system (IPSS) risk, and chromosome karyotype.

METHODS

There were 124 MDS patients subjected to the tests. By FAB typing, 91 patients were typed as refractory anemia (RA) type and 33 as refractory anemia with excess of blasts (RAEB) type; by IPSS scale, 21 were sorted to low risk, 77 to moderate risk I, 20 to moderate risk II, and 6 to high risk; 78 of them had normal chromosome and 46 with abnormal chromosome, including 26 of trisomy 8. All patients were treated with QHP+BPYS, and the changes of peripheral blood figure and bone marrow were observed.

RESULTS

After treatment, the general effective rate was 72.58% (90/124), which in the patients of RA type was 80.22% (73/91) and in RAEB type 51.52% (17/33). The former was better than that in the later (P<0.01). For the analysis in the patients of different IPSS risk degrees, the effective rate was 95.24% (20/21) in the lowrisk group, 72.73% (56/77) in moderate risk I, 65.00% (13/20) in moderate-risk II, and 16.67% (1/6) in high-risk group. Those in the first two groups were superior to that in the latter two (P<0.01). The effective rate was 79.49% (61/78) in the patients with normal chromosome and was 60.87% (28/46) in the patients with abnormal chromosome, showing a significant difference between them. While in the patients of trisomy 8, it was 73.08% (19/26), which was parallel to that in the patients with normal chromosome.

CONCLUSION

The effectiveness of QHP+BPYS comprehensive therapy for MDS is unquestionably good, and it is markedly correlated with the FAB type and IPSS risk degree of the disease, as well as the normality of chromosome in the patient.

摘要

目的

观察青黄散(QHP)联合补髓益血汤(BPYS)治疗骨髓增生异常综合征(MDS)的临床疗效及其与 FAB 分型、国际预后评分系统(IPSS)危险度、染色体核型的关系。

方法

124 例 MDS 患者接受了测试。根据 FAB 分型,91 例为难治性贫血(RA)型,33 例为难治性贫血伴原始细胞增多(RAEB)型;根据 IPSS 量表,21 例为低危,77 例为中危 I,20 例为中危 II,6 例为高危;78 例染色体正常,46 例染色体异常,包括 26 例三体 8。所有患者均采用 QHP+BPYS 治疗,观察外周血象和骨髓象的变化。

结果

治疗后总有效率为 72.58%(90/124),RA 型患者为 80.22%(73/91),RAEB 型为 51.52%(17/33)。前者优于后者(P<0.01)。对于不同 IPSS 风险程度患者的分析,低危组有效率为 95.24%(20/21),中危 I 组为 72.73%(56/77),中危 II 组为 65.00%(13/20),高危组为 16.67%(1/6)。前两组优于后两组(P<0.01)。染色体正常患者有效率为 79.49%(61/78),染色体异常患者有效率为 60.87%(28/46),两者差异有统计学意义。而在三体 8 的患者中,有效率为 73.08%(19/26),与染色体正常的患者相似。

结论

QHP+BPYS 综合治疗 MDS 的疗效无疑是好的,与疾病的 FAB 分型和 IPSS 危险度以及患者染色体的正常性明显相关。

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