甘露聚糖肽和地榆升白片对放射治疗中白细胞减少症的临床评价

摘要

目的：对甘露聚糖肽与地榆升白片在恶性肿瘤放射治疗(放疗)中改善白细胞减少症的临床价值评价。方法：共纳入142例患者,随机分为两组：甘露聚糖肽组70例,口服胶囊2粒/次,3次/d；地榆升白片组72例,3片/次,3次/日。放射治疗方案：采用6MV-X线直线加速器外照射患者,均采用常规分割式外照射,即1周5天,1天1次,一次DT1.8~2Gy,总量为DT44~70Gy(6到7周)。应用前瞻性、开放性和平行对照方法,观察两者外周血白细胞水平变化及安全性指标。结果：甘露聚糖肽组与地榆升白片组在显效率(47.46% vs 31.67%,P=0.035)方面,提升白细胞水平效果方面[(7.0±0.8) vs (5.4±0.9),P=0.005],白细胞数目的最低值[(3.6±0.5) vs (3.2±0.4),P=0.04]以及两组患者人均集落刺激因子量[(0.59±1.13) vs (2.06±3.75),P=0.004)具有统计学意义。随访2年,两组患者生活质量的评分以及不良反应的情况中,甘露聚糖肽组均好于地榆升白片组。结论：甘露聚糖肽和地榆升白片两组药物均能显著升高白细胞水平,然而甘露聚糖肽的临床价值更好。%Objective:To evaluate the Clinical value of mannan peptide and Diyu-Shengbai tablet on radiothernpy induced leukopenia.Methods:A prospective parallel randomized controlled clinical study was conducted to compare the clinical value evaluation of one hundred and forty-two cases with malignancy were randomly divided into two groups,mannan peptide group (70 patients),the average daily dose is 2 capsules 3 times daily and radiothernpy;and Diyu-Shengbai tablet group (72 patients),the average daily dose is 3 tablets 3 times daily and radiothernpy.Radiation therapy program:6MV-X line linear accelerator patients with external beam radiation.DT1.8~2Gy a day,five days a week,the total is DT44~70Gy.Comparison was made on the efficacy and safety of leukocytes between mannan peptide group and Diyu-Shengbai tablet group.Results:The Significant efficiency between mannan peptide group and Diyu-Shengbai tablet group (47.46%vs 31.67%,P=0.035) the number of WBC in first week [(7.0±0.8) vs (5.4±0.9),P=0.005],the minimum number of WBC [(3.6±0.5) vs (3.2±0.4),P=0.04],and the means of used dose of rhG-CSF [(0.62±1.43) vs (2.17±4.05),P=0.005]with a statistics difference after follow-up.There are fewer adverse reactions cases and they are not serious in mannan peptide group.Conclusion:Mannan peptide and Diyu-Shengbai tablet both can significantly elevated white blood cell levels on radiothernpy induced leukopenia,however,mannan peptide is better than Diyu-Shengbai tablet in this study.