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含砷化合物-青黄散治疗骨髓增生异常综合征临床安全有效方法的研究

Study on the Clinical Safe and Effective Methods of Arsenic-Containing Compound-Qinghuang Powder in the Treatment of Myelodysplastic Syndrome.

作者信息

Zhu Qianzhe, Deng Zhongyang, Zhu Shirong, Zhao Pan, Wang Mingjing, Hu Xiaomei

机构信息

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

出版信息

Evid Based Complement Alternat Med. 2017;2017:2095682. doi: 10.1155/2017/2095682. Epub 2017 Nov 16.

Abstract

OBJECTIVE

To establish the clinical safe and effective methods of arsenic-containing compound-Qinghuang Powder (compound-QHP) in the treatment of myelodysplastic syndrome (MDS).

METHODS

200 patients with MDS were treated with compound-QHP (daily dose of 0.1 g realgar). The blood arsenic concentrations (BACs) were detected by atomic fluorescence spectrophotometry (HF-AFS). After treatment for 1 month, the patients were randomly divided into group A and group B when the BACs were less than 20 g/L. Daily dose of realgar was maintained in group A and it was increased to that when the BACs were more than 20 g/L in group B. The BAC and clinical efficacy and safety in two groups were compared at the end of the treatment with compound-QHP.

RESULTS

The average BAC of group B was significantly higher than that of group A ( < 0.01). The rates of hematology improvement and reduced transfusion were significantly higher in group B than in group A ( < 0.05). The HGB, ANC, and PLT significantly increased in group B after treatment ( > 0.05).

CONCLUSIONS

Monitoring the BAC and adjusting the daily dose of realgar to increase the effective BAC and then improving efficacy without increasing the clinical toxicity are the clinical safe and effective methods in the treatment of MDS.

摘要

目的

建立含砷化合物青黄散(复方青黄散)治疗骨髓增生异常综合征(MDS)的临床安全有效方法。

方法

200例MDS患者采用复方青黄散治疗(雄黄日剂量0.1g)。采用原子荧光分光光度法(氢化物发生-原子荧光光谱法,HF-AFS)检测血砷浓度(BAC)。治疗1个月后,当BAC小于20μg/L时,将患者随机分为A组和B组。A组维持雄黄日剂量不变,B组当BAC大于20μg/L时增加雄黄日剂量。在复方青黄散治疗结束时比较两组的BAC、临床疗效及安全性。

结果

B组平均BAC显著高于A组(P<0.01)。B组血液学改善率和输血减少率显著高于A组(P<0.05)。B组治疗后血红蛋白(HGB)、中性粒细胞绝对值(ANC)和血小板(PLT)显著升高(P>0.05)。

结论

监测BAC并调整雄黄日剂量以提高有效BAC,进而在不增加临床毒性的情况下提高疗效,是治疗MDS的临床安全有效方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e22b/5733968/382a27cd99e6/ECAM2017-2095682.001.jpg

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