摘要
目的:探究以硼替佐米为基础的三联化疗联合参芪扶正注射液治疗多发性骨髓瘤伴肾功能不全患者的疗效及不良反应发生情况。方法:纳入103例气血两虚型多发性骨髓瘤伴肾功能不全患者,随机分为对照组(51例)与研究组(52例)。对照组采用以硼替佐米为基础的三联化疗,研究组加用参芪扶正注射液。比较两组患者疗效、中医证候积分、生活质量评分、造血功能、肾功能、免疫功能及不良反应发生情况。结果:对照组临床总缓解率(70.83%)与研究组临床总缓解率(79.17%)比较,差异无统计学意义(P>0.05)。治疗后,两组患者中医证候积分、NRS均低于治疗前,KPS高于治疗前,且研究组变化幅度高于对照组(P<0.05)。治疗后,两组患者WBC、Hb、PLT均低于治疗前,且研究组治疗后WBC、Hb、TLT均高于对照组(P<0.05)。治疗后,两组患者Scr、BUN、24 h尿蛋白量均低于治疗前,且研究组治疗后Scr、BUN、24 h尿蛋白量均低于对照组(P<0.05)。治疗后,两组患者CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)水平均显著高于治疗前,且研究组治疗后CB3^(+)、CD4^(+)、CD4^(+)/CD8^(+)均高于对照组(P<0.05)。研究组骨髓抑制发生率(18.75%vs39.58%)、恶心呕吐发生率(14.58%vs33.33%)、Ⅲ-Ⅳ级周围神经病变发生率(10.42%vs29.17%)显著低于对照组(P<0.05)。结论:硼替佐米三联化疗联合参芪扶正注射液治疗能够显著提高多发性骨髓瘤伴肾功能不全患者生活质量,减轻化疗对患者骨髓造血功能的抑制,改善肾功能,提高细胞免疫功能,降低化疗相关不良反应的发生率。
Objective:To investigate the efficacy and adverse reactions of bortezomib-based triplet chemotherapy combined with Shenqi Fuzheng injection for multiple myeloma patients with renal insufficiency.Methods:Totally 103 patients with multiple myeloma with renal insufficiency of Qi and blood deficiency,were selected as the research object,and the patients were randomly divided into control group(n=51)and research group(n=52).Patients were given bortezomib triple chemotherapy in control group,while additional Shenqi Fuzheng injection in research group.The curative effect,traditional Chinese medicine(TCM)syndrome score,quality of life score,hematopoietic function,renal function,immune function and adverse reactions were compared between the two groups.Results:After corresponding treatments,there was no statistical difference between the clinical total remission rate of the control group(70.83%)and that of the research group(79.17%)(P>0.05).The TCM syndrome scores and bone pain symptom score(NRS)of both groups were lower than those before the treatments,while the KPS was higher than that before the treatments,and the research group showed more significant changes than control group(P<0.05).Both groups showed lower levels of WBC,Hb and PLT than before the treatments,and the research group showed higher WBC,Hb and PLT than control group(P<0.05).The levels of Scr,BUN and 24 h urinary protein in both groups were also lower than those before the treatments,and the research group showed lower Scr,BUN and 24 h urinary protein than control group(P<0.05).Moreover,the levels of CD3^(+),CD4^(+)and CD4^(+)/CD8^(+)in both groups were significantly higher than those before the treatments,and the research group showed higher CD3^(+),CD4^(+)and CD4^(+)/CD8^(+)than control group(P<0.05).The research group showed lower incidence of myelosuppression(18.75%vs 39.58%),nausea and vomiting(14.58%vs 33.33%)and gradeⅢ-Ⅳperipheral neuropathy(10.42%vs 29.17%)than control group(P<0.05).Conclusion:Bortezomib triple chemotherapy combined with Shen
作者
田昱平
陈玉博
李彤
彭飞
TIAN Yuping;CHEN Yubo;LI Tong;PENG Fei(Baoji Central Hospital,Baoji Shaanxi 721008,China;School of Traditional Chinese Medicine,Baoji Vocational&Technical College,Baoji Shaanxi 721013,China)
出处
《中医药导报》
2024年第9期41-46,共6页
Guiding Journal of Traditional Chinese Medicine and Pharmacy
基金
陕西省重点研发计划项目(2020SF-060)。
关键词
多发性骨髓瘤
肾功能不全
气血两虚
硼替佐米
参芪扶正注射液
免疫功能
multiple myeloma
renal insufficiency
Qi and blood deficiency
bortezomib
Shenqi Fuzheng injection
immunologic function
