青黄胶囊联合健脾补肾中药治疗低增生性骨髓增生异常综合征的疗效观察

·博士论坛·青黄胶囊联合健脾补肾中药治疗低增生性

骨髓增生异常综合征的疗效观察

王德秀1付中学2王洪志2朱千赜1许勇钢2麻柔2

【摘要】目的统计青黄胶囊联合健脾补肾中药方案对低增生性骨髓增生异常综合征（hypoplastic myelodys-

plastic syndrome，hypo－MDS）患者的近期及远期疗效，并对此类患者作分析探讨。方法回顾分析2010年4月至

2018年4月期间就诊于中国中医科学院西苑医院血液科门诊诊断为hypo－MDS接受青黄胶囊为主方案治疗12

个月及以上的38例患者资料，比较治疗前后外周血白细胞（white blood cell，WBC）计数、中性粒细胞（absolute neu-

trophil count，ANC）计数、血红蛋白（hemoglobin，HGB）计数、血小板（platelet，PLT）计数、红细胞输注依赖比例及骨

髓原始细胞数的变化，评估患者的近期及远期治疗反应和外周血情况。结果hypo－MDS较高增生或正常增生

MDS发病年龄低、染色体异常发生率低，危度分层集中在IPSS－Ｒ中低危组；治疗3、6、12个月时总有效率（完全

缓解+血液学进步）分别为52．6%、76．3%、86．8%；外周血HGB、PLT计数在治疗3、6个月后持续升高（P＜0．01），ANC计数在治疗6个月后升高（P＜0．05）；治疗12个月后，WBC、ANC、HGB、PLT计数均升高（P＜0．05），

92．3%（12/13）需红细胞输注患者逐渐脱离红细胞输注；治疗18个月、24个月、≥36个月、≥60个月有效率分别为97．1%、100%、96．6%、100%，18个月后不同治疗时间点疗效相仿（P＞0．05）；低危组患者与中危组患者在治疗3、6、

12个月时疗效相仿（P＞0．05）。结论hypo－MDS与高增生或正常增生MDS在发病年龄、染色体异常发生率、危度

分层及预后转归可能有一定差别；青黄胶囊联合健脾补肾中药治疗方案对hypo－MDS患者可收获良好的近远期临

床疗效；青黄胶囊联合健脾补肾中药治疗方案可能对hypo－MDS患者外周血HGB计数的改善更早更显著。

【关键词】低增生性骨髓增生异常综合征；青黄胶囊；健脾补肾中药；近远期疗效；外周血象

【中图分类号】Ｒ331．2+2【文献标识码】A

Clinical observation on hypoplastic myelodysplastic syndrome treated with Qing-

huang capsule combined with Jianpi Bushen Decoction

WANG De－xiu1，FU Zhong－xue2，WANG Hong－zhi2，ZHU Qian－ze1，XU Yong－gang2，MAＲou2

（1．Graduate School，China Academy of Chinese Medical Sciences，Beijing100700；2．Department of Hematology，Xiyuan Hospital，China Academy of Chinese Medical Sciences，Beijing100091）

【Abstract】Objective To analyze and Evaluate the short－term and long－term effectiveness on hypocellular myel-odysplastic Syndromes（hypo－MDS）treated with Qinghuang capsule combined with Jianpi Bushen Decoction．Methods38

hypo－MDS patients treated with Qinghuang capsule and Jianpi Bushen Decoction for more than12months from April

2010to April2018in Chinese Academy of Traditional Chinese Medicine was retrospectively analyzed．The short－term and

long－term treatment response and peripheral blood change were evaluated to compare with change of WBC，ANC，HGB，

PLT，erythrocyte infusion dependency ratio and primitive bone marrow cells before and after treatment．Ｒesults Hypo－

MDS patients with higher or normal proliferation had lower age of onset and lower incidence of chromosomal abnormalities．

Ｒisk stratification was concentrated in the middle and low risk group of IPSS－Ｒ．The total effective rates including com-

plete remission and hematological progress were52．6%，76．3%and86．8%respectively after3，6and12months of treat-ment．The HGB and PLT in peripheral blood were increased continuously after3and6months of treatment（P＜0．01），

while ANC increased after6months of treatment（P＜0．05）．The WBC，ANC，HGB and PLT were increased after12

months of treatment（P＜0．05）．92．3%（12/13）of patients who received red blood cell transfusion gradually were gradu-

ally free of erythrocyte infusion．The effective rates of18months，24months，more than36months and60months were 97．1%，100%，96．6%and100%respectively and had no difference with each other（P＞0．05）．the curative effects of

low－risk group and middle－risk group were similar after3，6and12months of treatment（P＞0．05）．Conclusions Hy-

po－MDS may be different from hyperproliferative or normal hyperplasia MDS in the age of onset，chromosomal abnormality，

DOI：10．13935/j．cnki．sjzx．190301

基金项目：国家自然科学基金面上项目（81273931）；国家自然科学基金青年科学基金项目（81503429）

作者单位：1．中国中医科学院研究生院，北京100700；2．中国中医科学院西苑医院血液科，北京100091

通讯作者：麻柔，Email：xyxysys@163．com