| Objective:To investigate the factors influencing the effect of Yisui Qinghuang Powder for treatment of myelodysplastic syndromes, on the basis of observations on clinical therapeutic effect.Methods:44 MDS patients were treated with Yisui Qinghuang Powder in 2 months for a course, in our clinics and wards from January 2006 to November 2010.Clinical therapeutic effect was observed the end of 2 courses and the effects of different factors on therapeutic effect was investigated.Results:(1) MDS patients treated with Yisui Qinghuang Powder total remission (CR+PR+MCR+HI) of 61.4%, total effective rate is 84.1%; clinical symptoms improved significantly after treatment, the increases of peripheral blood ANC and HBG are significant (p<0.05),the patients of remission (CR+PR+MCR+HI) get much better effect and initial cells rate in bone marrow is slightly lower(p>0.05);the bone marrow hyperplasity is tendency to normal after treatment in patients with hyperplasity too active or low.(2) The Group's total effect without blood transfusion before the treatment is not significantly different from blood transfusion group (P>0.05), but the lifetime in patients dependent on blood transfusions are significantly reduced (p<0.05).(3) The Group's total effect are not significant different, comparing the ANC<0.5x109/L group and>0.5x109/L group before treatment (P>0.05);no significant effects on the patient's survival, either (P>0.05).(4) Of different ages, gender, FAB subtypes, IPSS classification, treatment course length, TCM syndromes, primary/secondary, and primary/retreated, Yisui Qinghuang Powder did not significantly affect the treatment of MDS (P>0.05).(5) 2 courses of the observation period, that is, within 4 months, effective rate monthly increase: most patients after a (63%) were given effect,2 courses up to maximum effective rate (96.3%). Some effective patients continuentur remedia after 2 courses, the global effect was further improved. After treatment of Yisui Qinghuang Powder, Erythron series is reacted fastest,1 course of treatment in patients with 56.3% HI-E;and Granulocyte and Megakaryocytic series are slower.(6) Comparing the bone marrow erythroid in different therapeutic effect of groups, found that median erythroid proportion for the CR+MCR group 58%,HI group 43.5%,SD and fail groups 34.25%, respectively. SD group and CR+MCR group of which there are significant differences (p<0.05)。(7) The survival curves show, for effective patients (CR+PR+MCR+HI), the surial is significantly higher than invalid patients (SD+failure), but this was not statistically significant (P>0.05), which probably relevant to most patients still alive in the short observation period.Conclusions:1. Yisui Qinghuang Powder has definite effect for treatment of MDS, it makes hemoglobin and neutrophils increase significantly, but no significant effect for platelets.2. Gender, age, disease critical degree, whether primary, whether initial treatment, TCM syndrome types are not obviously affect the curative effect (P> 0.05).3. Blood transfusion or not, the amount of blood given,and the ANC before treatment,are not factors significantly affecting curative effect of Yisui Qinghuang Powder.4. Course of treatment is closely related with curative effect, as the courses increace, efficient rate gradually raised, and some patients are being further improved overall.5. Bone marrow erythroid proportion is closely related with curative effect. Effect of bone marrow erythroid in a high proportion of patients is better, and the curative effect is more complete.6. Blood transfusion or not, to some extent, influences long survive of patients, the lifetime in patients who dependent on blood transfusions are significantly reduced, so early treatment should be advocated.7. For the patients of remission (CR+PR+MCR+HI), the clinical symptoms improved significantly, survival quality were improved. And survival time were prolonged in initial research, but it need to be confirmed in the future. |
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