| Objective and Methods:In order to further clarify the treatment effect of Yisui Paste combined with erythropoietin on all types of MDS patients, observe whether they have impact on stabilizing the peripheral blood and improve clinical symptoms and quality of life, observation has been conducted in Beijing University of Chinese Medicine Oriental Hospital hematology ward for30MDS patients from December2010to February2014. This is to evaluate the clinical efficacy of Yisui Paste combined with erythropoietin for MDS patients, observe whether they have impact on stabilizing the peripheral blood, improve clinical symptoms and quality of life and analyze some factors that may have an impact on efficacy.Results:(1) analysis of total clinical efficacy:revised according to the end of2000(IWG) MDS treatment response criteria for judging criterion, in30patients, partial remission in1case; Hematology progress in6cases;13.cases were stable;10cases were ineffective; the total effective rate was66.7%, and according to the patient’s risk rating for the4part, data by chi square test, comparison of MDS low, in high-risk patients, by the total clinical curative effect after the treatment, P<0.005, The clinical efficacy of MDS in patients with different risk factors with significant difference. In table33A Comparison of efficiency, suggesting that the treatment scheme for the IPSS risk classification in Ⅱ score lower than critical patients with MDS have a certain effect, in the high risk group of basic invalid.(2) analysis of the clinical symptoms of change:the comparison of the clinical symptoms score before and after treatment were compared:the total integral, mean comparison shows, after treatment were decreased, but the non parameter Wilcoxon test, P>0.05, no significant difference. Our analysis has several possibilities, one is indeed like a statistical test that no improvement in clinical symptoms; two is the small sample data can not reflect the changes of clinical symptoms; three is due to differences in change of each symptom, the authenticity of the general observation of total score changes may cover part of clinical effect. To this end we will top three symptoms and were detected. Comparison of clinical symptom score:data by non parameter Wilcoxon test, Shenpi fatigue symptom integral comparison of P<0.05, showed that after treatment, Shenpi fatigue remission. Haemorrhage symptom P value>0.05, show that before and after the treatment of bleeding symptoms had no significant statistical difference. Blood stasis symptoms P value>0.05, blood stasis symptoms before and after treatment showed no change. To sum up, the whole treatment after symptoms were eased slightly, the lassitude is improved obviously, bleeding and blood stasis symptom treatment did not change the ideal.(3) analysis of peripheral blood changes:the total white cell count and neutrophil count:average treatment may have to increase, but no statistical difference, suggesting that the treatment had no obvious effect on enhancing the total number of white blood cells and neutrophils, but can not be ruled out because the number of samples is small is not completely response the real results treatment, need to be further expanded the sample to observe; the red blood cell and hemoglobin:there were significant differences in the changes of red cell in patients before and after treatment. The treatment can improve content of red blood cells in peripheral blood of patients with hemoglobin; before and after treatment the mean increased slightly and the mean standard deviation is smaller, but there was no significant difference in hemoglobin, suggesting no significant increase, but the combination of a number of red blood cells before and after treatment increased, the deviation does not rule out the small sample size calculation result of the need to further expand the sample, to observe the. The change of platelet platelet:no significant difference before and after treatment. The treatment had no obvious effect to improve platelet numbers.(4) bone marrow changes analysis:because of the small number of cases before and after bone marrow cytology treatment contrast, can not be analyzed statistically, clinical work in the future to continue to carry out the study.(5) the immunological changes analysis:because the patient personal wishes, only7people were less than before and after the treatment,10cases, is not suitable for the use of statistics analysis, and the expression of the above information is only CD34+, CD34molecules or not, without CD34+, CD34count data, can not be observed the change trends of the CD34+, CD34, and so can not determine the the type of immune therapy has no effect, clinical work in the future to continue to carry out the study.(6) the relative factors to the effect:the relationship between disease and RBC and changes of HGB:because the total number of cases in this group the small sample size, type of disease distribution data is loose and the number of differences such as MDS-RA to a maximum of9cases of type MDS-MPD, the least number of1cases, these factors will inevitably have on the statistical analysis result deviation and disturbance, so between the patients are still unable to accurately reflect the disease type and RBC and HGB effect. To continue to expand the trend of total sample uniform disease type data distribution, to obtain accurate statistical data. The relationship of risk classification and the RBC and HGB changes:repeated measurement data results show that for different risk levels in patients with RBC and HGB, erythropoietin combined with Yisui ointment treatment effect differences, the best treatment effect for patients at low risk of0points for high-risk patients, results are not satisfactory.Conclusion:①Erythropoietin combined with Yisui paste can improve the clinical symptoms of MDS patients, and improve their quality of life. Among all symptoms, lassitude has the most outstanding effects; however, there is no change of symptoms in the bleeding and blood stasis.②Erythropoietin combined with Yisui paste has the best effects on the patient of risk classification0in improving the RBC and HGB.③Erythropoietin combined with Yisui paste has no obvious effects on improving platelet count.④Due to the incompleteness of the data observed in this study, it is hard to get to the exact conclusions about the effects of Erythropoietin combined with Yisui paste on total white blood cells, the number of neutrophili、the changes of bone marrow and cell immunophenotype. The further observation is still needed. |
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