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目的:分析苦参碱治疗多发性骨髓瘤(MM)的疗效和毒副作用。方法:将74例MM患者分为2组:长春新碱+阿霉素+地塞米松(VAD)组35例,给予基础治疗,苦参碱+VAD组39例,在基础治疗的基础上给予苦参碱,28d为1个疗程。以胸片、心电图、骨髓穿刺结果、血清免疫球蛋白水平、血清免疫固定电泳、血尿本周氏蛋白电泳、24h尿蛋白定量、肝肾功能与全血细胞计数检查结果为指标,根据美国国立综合癌症网络(NCCN)2009年国际骨髓瘤工作组(IMWG)标准疗效判断标准(疗效评估分为完全缓解(CR)、非常好的部分缓解(VGPR)、部分缓解(PR)、稳定(SD)和疾病进展(PD))进行疗效评估,并统计不良反应。结果:苦参碱+VAD组和VAD组CR患者比例分别为12.8%和8.6%,无显著性差异;VGPR患者比例分别为33.3%和11.4%,有显著性差异(P<0.05);PR患者比例分别为46.2%和45.7%,无显著性差异;苦参碱+VAD组恶心呕吐、乏力、发热出现的比率显著低于VAD组(P<0.05),出现腹部不适的比例2组间比较无显著性差异;两组均未出现心动过速、化疗相关死亡情况。结论:苦参碱有助于提高多发性骨髓的缓解率与减少化疗相关不良反应。
Objective: To analyze the curative effect and toxicity of matrine in treating multiple myeloma (MM). Methods: Thirty-four patients with MM were divided into two groups: vincristine + doxorubicin + dexamethasone (VAD) group, 35 cases were treated with matrine + VAD group, 39 cases were given on the basis of treatment Matrine, 28d for a course of treatment. The results of chest X-ray, electrocardiogram, bone marrow aspirate, serum immunoglobulin, serum immunoelectrophoresis, hematuria week protein electrophoresis, 24h urinary protein, liver and kidney function and whole blood count were used as indexes. According to the National Comprehensive Cancer (NCCN) criteria for the evaluation of the standard efficacy of the International Society for Myeloma 2009 (efficacy evaluation divided into complete remission (CR), very good partial response (VGPR), partial remission (PR), stable (SD) Progress (PD)) for efficacy evaluation, and statistical adverse reactions. Results: The proportion of CR patients in matrine + VAD group and VAD group was 12.8% and 8.6%, respectively, with no significant difference. The proportion of patients with VGPR was 33.3% and 11.4%, respectively, with significant difference (P <0.05) The rates of nausea and vomiting, fatigue and fever in matrine + VAD group were significantly lower than those in VAD group (P <0.05), and there was no significant difference between the two groups Significant difference; no tachycardia, chemotherapy-related deaths occurred in both groups. Conclusion: Matrine helps to improve the remission rate of multiple myeloma and reduce chemotherapy-related adverse reactions.