硼替佐米为主化疗方案辅以中药治疗多发性骨髓瘤骨病疗效观察

摘要

目的：探讨硼替佐米为主化疗方案辅以中药治疗多发性骨髓瘤骨病临床疗效及安全性。方法选取收治多发性骨髓瘤骨病患者共150例，以随机区组法分为A、B、C组，每组50例，分别给予VAD方案、VAD方案＋硼替佐米及VAD方案＋硼替佐米＋祛瘀散结汤治疗，比较3组临床疗效，生活质量改善率、治疗前后疼痛数字评分（NRS评分）、白介素-6（IL-6）、C-反应蛋白（CRP）水平及药物毒副作用发生率等。结果 C组患者临床疗效均显著优于A组和B组，差异有统计学意义（ P ＜0．05）；C组患者生活质量改善率均显著高于A组和B组，差异有统计学意义（ P ＜0．05）；C组患者治疗后NRS评分均显著低于A组、B组及治疗前，差异有统计学意义（ P ＜0．05）；C组患者治疗后IL-6和CRP水平均显著低于A组、B组及治疗前，差异有统计学意义（ P ＜0．05）；同时C组患者药物毒副作用发生率均显著低于A组、B组，差异有统计学意义（ P ＜0．05）。结论祛瘀散结汤辅助硼替佐米为主化疗方案治疗多发性骨髓瘤骨病可有效控制病情进展，改善生活质量，减轻疼痛程度和炎性反应水平，且有助于降低药物不良反应发生风险。%Objective To investigate the therapeutic effects and safety of traditional Chinese medicine ( TCM ) combined with chemotherapy ( bortezomib ) on multiple myeloma .Methods One hundred and fifty patients with multiple myeloma who were admitted and treated in our hospital from May 2012 to May 2015 were randomly divided into group A ,group B and group C ,with 50 patients in each group .The patients in group A were treated by VAD scheme , and the patients in group B were treated by VAD scheme +bortezomib, however, the patients in group C were treated by VAD scheme +bortezomib+Quyusanjie decoction .The clinical curative effects ,improvement rate of life quality , NRS score, levels of IL-6, CRP before and after treatment , and the incidence of adverse drug effects were observed and compared among the three groups.Results The clinical curative effects in group C were significantly better than those in group A and group B ( P <0.05).After treatment the improvement rate of life quality in group C was significantly higher than that in group A and group B ( P <0.05).The NRS scores in group C after treatment were significantly lower than those before treatment and those in group A and group B ( P <0.05).The levels of IL-6 and CRP in group C after treatment were significantly lower than those before treatment and those in group A and group B ( P <0.05).Moreover the incidence of adverse drug effects in group C was significantly lower than that in group A and group B ( P <0.05 ).Conclusion Quyusanjie decoction combined with chemotherapy ( mainly bortezomib ) in treatment of multiple myeloma can effectively control the disease progress , improve life quality of patients , relieve pain degree and inflammatory reaction levels , moreover ,which is helpful to decrease the incidence of adverse drug reactions .