Study On The Relationship Between The Distributions Of TCM Syndromes And The Level Of Serum 25(OH)D In Patients With Acute Myeloid Leukemia

ObjectiveAcute myeloid leukemia is a kind of common hematologic malignancy.The effect of cellular and molecular genetic abnormalities in the pathogenesis of AML is illuminated gradually.According to the study in recent years,we can find that vitamin D possesses the capacity of anti-leukemic.vitamin D has anti-proliferation for leukemia cells and induce them to differentiate by cell signal transduction pathway to influence the growth and proliferation of cells so that the occurrence and development of disease can be affected.Traditional Chinese Medicine believe that AML belongs to a kind of consumptive disease.Righteous qi deficiency and evil qi excess is the main pathogenesis of acute leukemia,especially the kidney-deficiency.The kidney-deficiency and the subtle materials of body are each other’s essential prerequisites and do harm to righteous qi of the body further.Also,they influence the prognosis of AML.Our traditional Chinese medicine believe that vitamin D belongs to the nutrient substance of body.This experiment is aim at exploring the relationship among the distribution of TCM syndromes of acute myeloid leukemia,the level of serum 25(OH)D of patients with AML and the risk stratification of diseases so that we can explore a new reference direction for the treatment of AML.MethodsAccording to the requirement of this experiment,we collected 30 cases of the patients who were diagnosed newly to suffer acute myeloid leukemia from April,2016 to January,2017 from hematology department of the First Affiliated Hospital of Guangdong University of Traditional Chinese Medicine.At the same time,we collected the four methods of diagnosis of these patients when they were diagnosed newly to suffer acute myeloid leukemia.By discriminating carefully,we confirmed the syndrome types of these patients with AML and these patients were classified as the exuberance of heat toxin syndrom、the deficiency of spleen yang and kidney yang syndrome、the deficiency of qi and blood syndrome、the deficiency of yin and exuberance of fire syndrome.Also,we have improved those related laboratory examinations,including ① Blood routine examination,biochemistry,blood coagulation,etc.② Marrow morphology(cellular morphology and immunohistochemistry;③ Cytogenetics(the chromosome check);④Molecular testing(the related genetic mutation of AML);⑤ flow cytometry of the marrow cells(immunophenotyping).What’ s more,according to the above checks and results,we validated the risk stratification of those patients with AML who were diagnosed newly.Then,according to the requirements of those experiments,we tested the 25-(OH)D level of these patients when they were diagnosed newly to chemotherapy and after the first chemotherapy.We collected the datum of the above experiments and adopted SPSS 21.0 APP to make the statistics to explore the relationship between the distribution of TCM syndromes of AML and the level of the serum 25(OH)D of patients with AML and the relationship between the risk stratification of patients with AML and the level of serum 25(OH)D of patients with AML.Results1.The level of serum 25(OH)D of patients with AML is lower than those average level of normal people and the difference has a significance of statistics.(P<0.05)2.The level of serum 25(OH)D of patients with AML of the different distributions of TCM syndromes of AML has obvious difference(P<0.05).The patients who belong to the deficiency of spleen yang and kidney yang syndrome are primarily lack of serum 25(OH)D,and the level of serum 25(OH)D of the patients belong to the other three syndromes are insufficient primarily.There are few patients with AML having the perfect level of serum 25(OH)D.The level of serum 25(OH)D of who belong to the exuberance of heat toxin syndrom can reach a ideal state.3.The level of serum 25(OH)D of the risk stratification of patients with AML have obvious difference(P<0.05).The high-risk patients with AML are primarily lack of serum 25(OH)D.The level of serum 25(OH)D of the low-risk patients with AML and the medium-risk patients with AML are insufficient primarily.4.The different distributions of TCM syndromes of AML and the level of the serum 25(OH)D of patients with AML have the correlation(P<0.05),The patients who belong to the deficiency of spleen yang and kidney yang syndrome are mainly the high-risk patients with AML.The patients who belong to the deficiency of qi and blood syndrome are mainly the medium-risk patients with AML.The patients who belong to the exuberance of heat toxin syndrom are half of the low-risk patients with AML and half of the medium-risk patients with AML.The patients who belong to the deficiency of yin and exuberance of fire syndrome are half of the medium-risk patients with AML and half of the high-risk patients with AML.5.After the first chemotherapy,the level of serum 25(OH)D of those patients with AML is higher than that before chemotherapy.The difference has a significance of statistics.(P<0.05)6.After the first chemotherapy,the difference between the level of serum 25(OH)D of those patients with AML and those normal people have no significance of statistics.(P<0.05)Conclusion1.The different distributions of TCM syndromes of AML and the level of the serum 25(OH)D of patients with AML have the correlation(P<0.05).The level of the serum 25(OH)D of the patients who belong to the deficiency of spleen yang and kidney yang syndrome is the lowest.2.The risk stratification of patients with AML and the level of serum 25(OH)D have the correlation(P<0.05).The lower the level of serum 25(OH)D is,the worse the prognosis is.3.The different distributions of TCM syndromes of AML and the different distributions of the prognosis of diseases have the correlation.The prognosis ofthe patients who belong to the deficiency of spleen yang and kidney yang syndrome is the worst.