扶正祛邪法联合减量去甲基化方案治疗老年急性髓系白血病的疗效与机制研究OA
Clinical efficacy and mechanisms of Fuzheng Quxie Method combined with reduced-dose demethylation regimen in the treatment of acute myeloid leukemia in the elderly
目的 观察扶正祛邪法(扶正祛邪复方加定清片)联合减量去甲基化方案治疗老年急性髓系白血病(acute myeloid leukemia,AML)的疗效及对转录激活因子4(activating transcription factor 4,ATF4)和白介素-6(interleukin-6,IL-6)的影响.初步探讨扶正祛邪法对老年急性髓系白血病的作用机制.方法 选择2021年8月至2022年12月在上海中医药大学附属岳阳中西医结合医院血液内科诊治的符合标准的60例老年AML(非M3型)患者,随机分为观察组、对照组2组,各30例.观察组采用扶正祛邪法联合减量去甲基化方案治疗,对照组采用标准去甲基化方案治疗,1个疗程为4周,3个疗程后进行统计分析和疗效评价,比较2组患者中医证候疗效、西医疗效、血常规、原始细胞比例、ATF4表达、IL-6水平.结果 观察组总有效率、中医证候疗效均优于对照组,在抑制白细胞异常增殖、提升血小板及血红蛋白方面也优于对照组;观察组ATF4表达治疗后高于治疗前,对照组无明显变化;治疗后2组IL-6水平均有所下降,观察组IL-6水平下降更为显著.结论 扶正祛邪法联合减量去甲基化方案治疗老年AML临床疗效以及中医证候疗效具有显著优势,能够有效抑制白细胞异常增殖,升高血小板及血红蛋白,且在基因表达和抑制炎症方面也具有优势.
Objective To observe the efficacy of the Fuzheng Quxie Method(Fuzheng Quxie compound formula combined with Dingqing Tablets)in combination with a reduced-dose demethylation regimen for the treatment of elderly patients with acute myeloid leukemia(AML),and to investigate its effects on activating transcription factor 4(ATF4)and interleukin-6(IL-6),thereby preliminarily exploring its mechanisms of action in elderly AML.Methods Sixty elderly patients with non-M3 AML who met the inclusion criteria and were treated in the Department of Hematology,Yueyang Hospital of Integrated Traditional Chinese and Western Medicine,Shanghai University of Traditional Chinese Medicine,from August 2021 to December 2022 were enrolled.Patients were randomly divided into two groups,with 30 cases in the observation group and 30 cases in the control group.The observation group was treated with the Fuzheng Quxie Method(Dingqing Tablets combined with Fuzheng Quxie compound formula)plus a reduced-dose demethylation regimen,while the control group received standard demethylation therapy.One treatment course was 4 weeks,and after 3 courses,clinical data were collected for efficacy evaluation and statistical analysis.Outcomes included traditional Chinese medicine(TCM)syndrome efficacy,Western medical efficacy,routine blood parameters,proportion of blast cells,ATF4 expression,and IL-6 levels.Results The observation group showed superior total effective rate and TCM syndrome efficacy compared with the control group.It also demonstrated better effects in inhibiting abnormal leukocyte proliferation and improving platelet and hemoglobin levels.ATF4 expression in the observation group increased after treatment compared with that before treatment,while no significant change was observed in the control group.After treatment,IL-6 levels decreased in both groups,with a more significant reduction observed in the observation group.Conclusion The Fuzheng Quxie Method combined with a reduced-dose demethylation regimen shows significant advantages in both clinical efficacy and TCM syndrome improvement in elderly AML patients.It can effectively inhibit abnormal leukocyte proliferation,increase platelet and hemoglobin levels,and also demonstrates advantages in regulating gene expression and suppressing inflammatory responses.
任梓瑞;王圣勇;陆皓;朱文伟;鲍计章
上海市第十人民医院崇明分院中医内科,上海 202157上海中医药大学附属市中医医院血液病科,上海 200071上海中医药大学附属岳阳中西医结合医院血液内科,上海 200437上海中医药大学附属岳阳中西医结合医院血液内科,上海 200437上海中医药大学附属市中医医院血液病科,上海 200071
扶正祛邪法老年人急性髓系白血病中药复方转录激活因子4临床疗效
Fuzheng Quxie Formulathe elderlyacute myeloid leukemiaChinese medicine compound formulaactivating transcription factor 4clinical efficacy
《北京中医药》 2026 (3)
310-316,7
上海市2022年度"科技创新行动计划"医学创新研究专项(22Y11921100)上海市中医医院未来计划-中医药科技发展项目(WL-XJRY-2021004K)上海市中医医院未来计划-院级青年名医项目(WLJH2021ZY-MZY033)国家中医优势专科建设(上海市中医医院血液病科)项目上海中医药大学"杏林传承"人才计划项目(上海中医药大学人事处[2019]10号文)上海市崇明区科学技术委员会科技项目(CKY2024-61)
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