祛瘀散结汤联合BRD治疗多发性骨髓瘤患者的疗效及机制探究

目的:探究祛瘀散结汤联合硼替佐米-来那度胺-地塞米松(BRD)治疗多发性骨髓瘤(multiple myeloma,MM)患者的疗效及对患者血清M蛋白(monoclonal protein),N末端B型利钠肽原(N-terminal pro-B-type natriuretic peptide,NT-proBNP)、肌钙蛋白Ⅰ(cardiac troponinⅠ,cTnI)水平的影响。方法:选择我院2017年1月~2020年1月收治的90例多发性骨髓瘤患者,根据其治疗方法分为研究组与对照组,每组各45例。对照组患者给予BRD化疗方案进行治疗,研究组在对照组基础上给予祛瘀散结汤,对比两组治疗后疗效,治疗前后骨痛症状、M蛋白、NT-proBNP、cTnI水平的变化及不良反应的发生情况。结果:治疗后,研究组的治疗有效率为91.11%,显著高于对照组(68.89%,P<0.05);两组的血清M蛋白和NT-proBNP水平较治疗前显著降低,且研究显著低于对照组(P<0.05),血清cTnI水平较治疗前显著升高,且研究组显著高于对照组(P<0.05);观察组治疗后骨痛评分显著低于对照组(P<0.05)。研究组治疗期间不良反应发生率11.11%,显著低于对照组发生率(28.89%,P<0.05)。结论:祛瘀散结汤联合BRD治疗MM患者可以显著提高患者的治疗效果,改善骨痛症状,安全性较高,可能与其降低M蛋白和NT-proBNP水平及升高cTnI水平有关。

Therapeutic Effect and Mechanism of Quyu Sanjie Decoction Combined with BRD on Patients with Multiple Myeloma

ABSTRACT Objective: To explore the efficacy of Quyu Sanjie Decoction combined with bortezomib-lenalidomide-dexamethasone (BRD) in the treatment of multiple myeloma patients and its effects on serum M protein, NT-proBNP, cTnI levels. Methods: Ninety patients with multiple myeloma from January 2017 to January 2020 in our hospital were selected and divided into the study group and the control group according to their treatment methods, with 45 patients in each group. The control group was treated with BRD chemotherapy regimen, and the study group was given Quyu Sanjie Decoction on the basis of control group. The therapeutic effect, the changes of symptoms of bone pain, M protein, NT-proBNP, cTnI levels before and after treatment and the occurrence of adverse reactions were compared between two groups. Results: The effective rate of treatment in the study group was 91.11 %, which was significantly higher than that of the control group (68.89 %, P<0.05). The serum M protein and NT-proBNP levels of both groups were significantly lower than before treatment, which was significantly lower than that in the control group (P<0.05), the serum cTnI levels were significantly higher than before treatment, which was significantly higher in the study group than that of the control group (P<0.05). The bone pain score in the observation group after treatment was significantly lower than that in the control group (P<0.05). The incidence of adverse reactions during the treatment group in the study group was 11.11 %, which was significantly lower that of the control group than (28.89 %, P<0.05). Conclusion: Quyu Sanjie decoction combined with BRD could significantly improve the therapeutic efficiency of MM patients, improve the symptoms of bone pain with higher safety, which may be related to the reduction of M protein and NT-proBNP levels and the increase of cTnI levels.