| BackgroundLeukemia is a kind of malignant clonal disease originated from hematopoietic stem cells,its onset is often acute,easy to repeat,and the prognosis is dangerous.Chemotherapy that can inhibit or kill such cells are still the primary treatment means for most leukemia patients,resulting to bone marrow depression as the most common and serious side effect of long-term and high-intensity chemotherapy.It will not only affect the clinical efficacy,but also cause many adverse reactions as followed,and even affect the quality of life of patients,finally life-threatening.Therefore,early prevention and improvement of bone marrow depression has greatly significance on clinical treatment of leukemia.Deficiency of Qi and blood is a common understanding of traditional Chinese medicine(TCM)for bone marrow suppression,and Bazhen decoction is the representative prescription of Qi and blood supplement.On the basis of strengthening Qi,nourishing Blood,reconciling Yin and Yang,modified Bazhen decoction has a good clinical effect on improving bone marrow depression after malignant tumor chemotherapy,enhancing effect and reducing toxicity.The clinical efficacy,safety and economy of bone marrow depression after leukemia chemotherapy are also worth exploring and discussing.PurposeRetrospective study was conducted to evaluate the improvement of modified Bazhen decoction in the treatment of bone marrow depression after leukemia chemotherapy,and to explore the role and advantages of traditional Chinese medicine in the process of adjuvant chemotherapy to enhance efficacy and reduce toxicity,so as to provide ideas and references for the future treatment of such disease.MethodsPatients diagnosed with leukemia and developed bone marrow depression during or after receiving chemotherapy in the case system of Nanfang Hospital,Southern Medical University from August 2019 to July 2021 were collected as research objects.By collecting case information through the electronic medical record platform,leukemia patients treated with chemotherapy alone were included in the control group,and patients treated with chemotherapy combined with modified Bazhen decoction were included in the treatment group.Peripheral blood trilineage of blood routine were collected from the day before chemotherapy and day 3,7,14,21 after chemotherapy both in control group and treatment group,the degree and incidence of bone marrow depression after chemotherapy was compared between the two groups.The changes of KPS score and TCM syndrome score(fatigue,diet,nausea and vomiting,dizziness and palpitation,spontaneous and night sweating)before and after chemotherapy were analyzed,and the improvement of quality of life of the two groups of patients was compared through KPS score and TCM syndrome score.The incidence of myelopathic drugs and blood transfusion,adverse reactions to chemotherapy(allergy,fever,infection,subcutaneous bleeding,liver function damage,abnormal renal function,cardiotoxicity,oral ulcer,gastrointestinal reactions),and the duration of hospitalization after chemotherapy were recorded.The clinical efficacy and safety of modified Bazhen decoction in the treatment of bone marrow depression after leukemia chemotherapy were evaluated and analyzed in all aspects.Result(1)Compared with the control group(81.8%),the incidence of myelosuppression in treatment group(50.0%)was significantly decreased(P<0.05),indicating that chemotherapy combined with modified Bazhen Decoction could significantly reduce the incidence of myelosuppression after chemotherapy,and it has a certain effect and significance on improving the level of RBC,HGB and PLT,and reducing the use of recombinant human Granulocyte Colony Stimulating Factor(P<0.05),while it has no obvious advantage to improve the level of WBC and reduce the blood transfusion.(2)Compared with the control group,the TCM syndrome score of the treatment group was significantly decreased(P<0.05),and the KPS score was significantly increased(P<0.05)after supplemented modified Bazhen Decoction,indicating that modified Bazhen Decoction combined with chemotherapy could effectively improve the quality of life of patients,compared with chemotherapy alone.(3)Comparison of adverse reactions:In terms of reducing the incidence of gastrointestinal reactions,fever,infection and oral ulcer,the curative effect of modified Bazhen decoction in the treatment group was significantly better than that in the control group(P<0.05),while it has no effect on reducing the incidence of liver damage,renal dysfunction,cardiotoxicity,hypersensitivity and subcutaneous bleeding(jP>0.05).(4)Compared with the control group,the duration of hospitalization after leukemia chemotherapy in the treatment group was significantly shortened(P<0.05).ConclusionThe modified Bazhen decoction is effective in reducing bone marrow depression and partial adverse reactions incidence of chemotherapy drug,improving the quality of life of patients,shortening the duration of hospitalization after leukemia chemotherapy,all above indicates that the modified Bazhen decoction has certain clinical efficacy,safety and economy. |
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