Objective It is to observe the clinical curative effect of TCM differential diagnosis by stages combined with chemotherapy in adult patients with acute myeloid leukemia ( AML) .Methods 129 patients with AML were randomly divided into four groups.31 cases in the control group were treated with standard dose of DA induction chemotherapy, and with con-ventional Western medicine in bone marrow suppression stage.35 cases in the treatment group Ⅰ were treated with Shenqi Shabai soup on the basis of standard dose of DA during induction chemotherapy, and with Shenqi Xianbu soup on the basis of conventional Western medicine in the bone marrow suppression stage.33 cases in the treatment group Ⅱ were treated with Shenqi Shabai soup on the basis of standard dose of DA during induction chemotherapy, and with the same plan of the control group in the bone marrow depression stage.30 cases in the treatment groupⅢwere treated with standard dose of DA induction chemotherapy, and with Shenqi Xianbu soup on the basis of conventional Western medicine in the bone marrow suppression stage.The therapeutic effect, the adverse reaction conditions, the hematopoietic recovery time and the infusion dose of blood products of the four groups were observed.Results The total efficiency of the treatment groupⅠand the treatment groupⅡwere significantly higher than that of the treatment group Ⅲ and the control group (all P<0.05), and there was no significant difference among the treatment groupⅠⅡand Ⅲ (P>0.05).The chemotherapy-related cardiac toxicity incidence of the the treatment groupⅠ,ⅡandⅢwere significantly lower than that of the control group (all P<0.05).The incidence of gas-trointestinal reactions, infecte, electrolyte disorder, liver and kidney damageIn of the treatment groupⅠ,ⅡandⅢwere sig-nificantly lower than those of control group (all P<0.05), and those of the treatment group Ⅰwere significantly lower than the others (all P<0.05).The hematopoietic recovery time and the infusion dose of blood products in the treatment gorupⅠ,Ⅲwere significantly lower, and the scores of the quality of life were significantly higher than those of the treatment group Ⅱand the control group (all P<0.05).Conclusion Shenqi Shabai soup can improve the side effects of chemotherapy, increase the remission rate.Xianbu soup is good at promoting the recovery of hematopoietic function, reducing blood products infusion. During the remission induction and bone marrow suppression stage, the sequential application of Shenqi Shabai soup and Shen-qi Xianbu soup can promote the increase the induced remission rate, and reduce the side reaction of heart and gastrointestinal tract, infection, liver and kidney damage and other adverse reactions caused by chemotherapy, and promote bone marrow hem-atopoietic recovery, reduce the blood products infusion, significantly improve the quality of life of patients with chemotherapy.%目的：观察中医分期辨治联合化疗治疗成人急性髓细胞白血病（ AML）患者的临床疗效。方法将129例AML患者随机分为4组：对照组31例诱导化疗期采用标准剂量的DA方案诱导化疗，骨髓抑制期予西医常规治疗；治疗Ⅰ组35例诱导化疗期在对照组治疗基础上给予参芪杀白汤口服，骨髓抑制期在对照组治疗基础上给予参芪仙补汤口服；治疗Ⅱ组33例诱导化疗期在对照组治疗基础上给予参芪杀白汤口服，骨髓抑制期治疗同对照组；治疗Ⅲ组30例诱导化疗期治疗同对照组，骨髓抑制期在对照组治疗基础上给予参芪仙补汤口服。观察4组治疗疗效、不良反应发生情况、造血恢复时间、血制品输注量及治疗前后生存质量评分。结果治疗Ⅰ组、治疗Ⅱ组总有效率均明显高于治疗Ⅲ组及对照组（P 均＜0.05），治疗Ⅰ组与治疗Ⅱ组比较差异无统计学意义（P＞0.05）。治疗Ⅰ组、治疗Ⅱ组、治疗Ⅲ组化疗相关心脏毒副反应发生情况均明显轻于对照组（P均＜0．05），治疗Ⅰ组、治疗Ⅱ组、治疗Ⅲ组间比较差异均无统计学意义（P均＞0.05）；治疗Ⅰ组、治疗Ⅱ组、治疗Ⅲ组胃肠道反应、感染、电解质紊乱、肝肾损害发生率均明显低于对照组（ P均＜0.05），且治疗Ⅰ组均明显低于治疗Ⅱ组和治疗Ⅲ组（ P均＜0．05）。治疗Ⅰ组、治疗Ⅲ组化疗后血细胞恢复时间及血制品输注量均低于治疗Ⅱ组和对照组（P均＜0．05），治疗后生存质量评分均高于治疗Ⅱ组和对照组（P均＜0．05）。结论参芪杀白汤善于改善化疗毒副反应，提高诱导缓解率；参芪仙补汤善于促进造血恢复，减少血制品输注。在AML化疗诱导缓解期、骨髓抑制期序贯联合应用参芪杀白汤、参芪仙补汤可提高诱导缓解率，减少化疗造成的心脏及胃肠道反应、感染、肝肾损害等不良反应，并可促进骨髓造血恢复，减少血制品输注，明显改善化疗患者生存质量。
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