| Purpose:To assess the effectiveness and safety of the Fuzheng Xiaoliu Sanjie Decoction combined with Metronomic chemotherapy for the elderly with "Deficiency and Toxin Stasis Type" non-Hodgkin lymphoma(NHL)and analyze its influence on patients’ quality of life.It willprovide practical references for the elderly NHL with both traditional Chinese and western medicine.Method:30 elderly NHL patients from the hematology department of Jiangsu Hospital of Traditional Chinese Medicine were enrolled from September 2018 to January 2021.All of them were treated with Fuzheng Xiaoliu Sanjie Decoction combined with etoposide capsule,lenalidomide and dexamethasone for four weeks as a course of treatment,which lasted for 6 months.The changes of β2-MG,LDH,IgM and superficial lymph node size were recorded before and after 1,2,4 and 6 months treatment.Chest and abdominal CT were reexamined every 3 months after treatment in order to evaluate the efficacy.Before and after 6 months treatment,patients were helped to fill in TCM syndrome rating scale,physical ECOG grading scale,and comprehensive geriatric assessment(CGA)in order to assess the changes in TCM function,physical status and comprehensive ability of patients.In addition,the observation indexes also included blood routine,liver and kidney function,electrocardiogram,adverse safety index,etc.SPSS23.0 was used for statistical description and analysis of the data,and(P<0.05)showed a statistical difference.Result:1.Among the enrolled NHL patients,using Fuzheng Xiaoliu Sanjie Decoction combined with Metronomic chemotherapy after 6 months treatment,the effective rate of TCM was 76.7%.The conditions of the 24 patients with complete CT data were evaluated,and 3 cases complete remission,15 cases partial remission,4 cases stable disease,and 2 cases disease progression.The clinical effective rate of Western medicine was 75%(18/24 cases).2.After 6 months treatment with Fuzheng Xiaoliu Sanjie Decoction combined with Metronomic chemotherapy,serum β2-MG,LDH and IgM of patients had a decreasing trend compared with pretherapy,in which serum β2-MG and LDH had statistical differences(P<0.05).β2-MG:pretherapy(3.93±1.84)μg/ml vs post-treatment(3.08±1.75)μg/ml(P<0.05);As for LDH:pretherapy(236.57±53.37)U/L vs post-treatment(226.73±74.72)(P<0.05).However,no statistical difference was shown between each treatment course(P>0.05).3.Combined with Metronomic chemotherapy,taking Fuzheng Xiaoliu Sanjie Decoction after 6 months treatment,shrank the superficial lymph nodes,pretherapy(2.91±3.22)cm2 vs post-treatment(2.20±2.67)cm2,with significant difference(P<0.05).4.After 6 months treatment,TCM symptoms were improved,and there was a statistical difference in syndrome scores compared with pretherapy(P<0.05).And the physical status,emotional cognitive status and nutritional status of 30 NHL patients in the comprehensive geriatric assessment(CGA)were improved,with statistical differences(P<0.05).5.Safety evaluation:30 patients were well tolerated and had good compliance with this regimen,and no one withdrew from the group due to adverse reactions.After 6 months treatment,the blood routine of the patient was slightly increased and maintained a stable state.WBC count:pretherapy(3.89±1.60)×109/L vs post-treatment(4.87±2.01)×109/L;Hb count:pretherapy(100.67±28.58)g/L vs post-treatment(110±28.57)g/L;PLTcount:pretherapy(108.80±29.51)×109/L vs post-treatment(129.73±46.36)×109/L.Some patients showed mild and moderate decrease of white blood cells,platelet and hemoglobin during the course,and a few patients showed mild diarrhea,which was improved after symptomatic treatment.Conclusion:Fuzheng Xiaoliu Sanjie Decoction combined with etoposide,lenalidomide,dexamethasone Metronomic chemotherapy for the elderly NHL has good clinical effect.It can improve clinical symptoms,reduce adverse reaction,improve the patient’s quality of life,so that it is worthy of clinical application. |
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