广西医学

目的探讨健脾益肾方联合CAG方案（阿糖胞苷+阿柔比星+重组人粒细胞集落刺激因子）治疗老年急性髓系白血病（AML）的有效性及安全性。方法将132例老年AML患者随机分为对照组和观察组，每组66例。给予对照组CAG方案治疗，观察组在对照组基础上服用健脾益肾方治疗。比较两组患者治疗前后的血常规、血生化指标（血清ALT、AST、β2微球蛋白、乳酸脱氢酶、肌酐、尿素氮水平）及生存质量，以及治疗后的临床疗效、治疗期间的输血量（红细胞悬液输入量、血小板输入量）及不良反应发生情况。结果治疗后，观察组的总有效率高于对照组，红细胞悬液输入量和血小板输入量少于对照组（P<0.05）。治疗后，两组患者的白细胞计数、中性粒细胞计数、血小板计数、网织红细胞计数及血清ALT、AST、肌酐水平和生存质量高于治疗前，血红蛋白水平、血清β2微球蛋白和乳酸脱氢酶水平低于治疗前，其中观察组的白细胞计数、中性粒细胞计数、血小板计数、网织红细胞计数和血清AST、肌酐及尿素氮水平高于对照组，血红蛋白水平和血清ALT、β2微球蛋白及乳酸脱氢酶水平低于对照组（P<0.05）。两组患者的不良反应总发生率差异无统计学意义（P>0.05）。结论健脾益肾方联合CAG方案治疗老年AML患者可提高临床疗效及生活质量，减轻血液学毒性反应，且安全性较好。

Objective To explore the effectiveness and safety of Jianpi Yishen Prescription combined with CAG regimen, namely, cytarabine plus aclarubicin plus recombinant human granulocyte colony⁃stimulating factor, for the treatment of elderly acute myeloid leukemia (AML). Methods A total of 132 elderly AML patients were randomly divided into control group or observation group, with 66 cases in each group. The control group received CAG regimen for treatment, based on which the observation group received Jianpi Yishen Prescription for treatment. The blood routine, blood biochemical indices with respect to serum ALT, AST, β2⁃microglobulin, lactate dehydrogenase, creatinine, urea nitrogen levels and quality of life before and after treatment, as well as post⁃treatment clinical efficacy, blood transfusion volume during treatment (transfusion volume of red blood cell suspension, transfusion volume of platelet) and adverse reactions were compared between the two groups. Results After treatment, the total effective rate in the observation group was higher than that in the control group, and the transfusion volumes of red blood cell suspension and platelet were lower than those in the control group (P<0.05). After treatment, patients of both groups obtained higher white cell counts, neutrophil counts, blood platelet counts, reticulocyte counts, and higher levels of serum ALT, AST, creatinine, as well as higher quality of life as compared with before treatment, whereas lower hemoglobin, serum β2⁃microglobulin and lactate dehydrogenase levels as compared with before treatment. Among which the observation group exhibited higher white cell counts, neutrophil counts, blood platelet counts, reticulocyte counts, and higher levels of serum AST, creatinine, and urea nitrogen, whereas lower levels of hemoglobin, serum ALT, β2⁃microglobulin, and lactate dehydrogenase as compared with the control group (P<0.05). There was no statistically significant difference in the total incidence rate of adverse reactions between the two groups (P>0.05). Conclusion Jianpi Yishen Prescription combined with CAG regimen for the treatment of elderly AML patients can improve their clinical efficacy and quality of life, relieve response to hematological toxicity, with a favorable safety.