| 引用本文:周庆兵1，王洪志2，王德秀2，朱千赜2，杨秀鹏2，许勇钢2，胡晓梅2，麻柔2.以雄黄为主方案治疗骨髓增生异常综合征伴多系病态造血患者的远期疗效[J].世界中医药,2019,(10):. |
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| 以雄黄为主方案治疗骨髓增生异常综合征伴多系病态造血患者的远期疗效 |
| Long-term Efficacy Observation on Realgar as the Main Scheme in the Treatment of Myelodysplastic Syndrome with Multilineage Dysplasia |
| 投稿时间：2018-06-08 |
| DOI：10.3969/j.issn.1673-7202.2019.10.052 |
| 中文关键词: 骨髓增生异常综合征伴多系病态造血 雄黄 远期疗效 青黄胶囊 中医药 髓毒劳 健脾补肾 回顾性分析 |
| English Keywords:Myelodysplastic syndrome with multilineage dysplasia Realgar Long-term efficacy Qinghuang Capsules Traditional Chinese medicine Marrow toxicity and consumption Supplementing spleen and kidney Retrospective study |
| 基金项目:北京市自然科学基金青年项目（7174344）；国家自然科学基金青年及面上项目（81603490,81273931） |
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| 目的：观察雄黄为主方案治疗骨髓增生异常综合征伴多系病态造血(MDS-MLD)患者的远期疗效。方法：选取2007年8月至2015年4月中国中医科学院西苑医院收治的MDS-MLD患者130例作为研究对象并进行回顾性分析，给予青黄散（雄黄、青黛）、健脾补肾汤药，治疗36个月及以上，以患者治疗前后外周血中性粒细胞(ANC)、血红蛋白(Hb)、血小板(PLT)为观察指标，评价治疗前后血液学改善情况，并比较不同遗传学分型疗效。结果：130例患者完全缓解、血液学进步、稳定、疾病进展分别为18例（13.84%）、80例（61.54%）、24例（18.46%）、8例（6.15%）；130例患者治疗前后外周血细胞ANC、Hb及PLT计数差异有统计学意义(P<0.05)；外周血三系血细胞疗效比较，Hb与ANC、Hb与PLT血液学改善程度差异有统计学意义(P<0.01)，而ANC与PLT血液学改善程度差异无统计学意义(P>0.05)；不同遗传学分型血液学改善程度比较，差异无统计学意义(P>0.05)。结论：以雄黄为主方案能改善MDS-MLD外周血象，对红系改善更为明显。 |
| English Summary: |
| To observe long-term efficacy on Realgar as the main scheme in the treatment of myelodysplastic syndrome with multilineage dysplasia(MDS-MLD).Methods:A total of 130 patients with MDS-MLD admitted in Xiyuan Hospital of China Academy of Chinese Medical Sciences from August 2007 to April 2015 were retrospectively analyzed and collected as subjects.These patients were treated by Qinghuang Powder(containing Realgar and Indigo Naturalis)and decoctions and herbs of supplementing spleen and kidney for 36 months at least.Peripheral blood neutrophils(ANC)，hemoglobin(Hb)and platelet count(PLT)were taken as observation indicators and calculated before and after the treatment，then the improvement of hematology before and after the treatment was assessed，and efficacies in different groups of genetics were compared.Results:In the 130 patients，rates of complete remission，hematological improvement，stability and disease progression were 13.84%(18 cases)，61.54%(80 cases)，18.46%(24 cases)and 6.15%(8 cases)respectively; count differences in the ANC，Hb and PLT of MDS-MLD patients before and after the treatment were statistically significant(P<0.01); comparison on efficacy in three-line blood cells of peripheral blood showed statistically significant differences in the hematological improvement between Hb and ANC，as well as Hb and PLT(P<0.01)，but there was no statistically significant difference in the hematological improvement between ANC and PLT(P>0.05); there was no statistical significant difference in the hematological improvement in different groups of genetics(P>0.05).Conclusion:Realgar as the main scheme can improve peripheral blood in patients with MDS-MLD and has a better effect on erythroid cells. |
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