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目的:观察中西医结合治疗促红细胞生成素(EPO)拮抗的肿瘤相关性贫血(CRA)患者的效果和安全性。方法:选取60例EPO拮抗的CRA患者作为研究对象,随机分为研究组和对照组各30例,研究组采用健脾益肾、气血双补法联合常规对症治疗,对照组以常规对症治疗,2组均治疗8周。观察2组患者治疗期间血红蛋白(Hb)、T淋巴细胞亚群(CD3,CD4,CD8,CD4/CD8)、自然杀伤(NK)细胞的变化情况以及不良反应。结果:2组Hb水平在治疗前、治疗7天以及治疗14天时比较,差异均无统计学意义(P>0.05),而研究组治疗21、28、35、42、49以及56天的Hb水平均较对照组增高,差异均有统计学意义(P<0.05)。治疗后,研究组CD3、CD4、CD8和NK细胞水平均较治疗前升高,CD4/CD8值较治疗前降低,差异均有统计学意义(P<0.05);2组各指标值比较,差异均有统计学意义(P<0.05)。研究组各项Ⅰ~Ⅱ度和Ⅲ~Ⅳ度不良反应的发生率均较对照组有所减少或一致,差异并不具有统计学意义(P>0.05)。结论:中西医结合治疗能有效提高EPO拮抗的CRA患者的Hb水平,改善机体免疫功能,并对减少治疗过程中不良反应的发生具有一定的作用。
Objective: To observe the efficacy and safety of the combination of traditional Chinese and western medicine in the treatment of erythropoietin (EPO) antagonist patients with tumor-associated anemia (CRA). Methods: 60 CRA patients with EPO antagonism were selected as study subjects and randomly divided into study group (30 cases) and control group (30 cases). The study group was treated with spleen and kidney, qi and blood combination therapy and conventional symptomatic treatment , Two groups were treated for 8 weeks. The changes of hemoglobin (Hb), T lymphocyte subsets (CD3, CD4, CD8, CD4 / CD8), natural killer (NK) cells and adverse reactions in the two groups were observed. Results: There was no significant difference in Hb levels between the two groups before treatment, 7 days after treatment and 14 days after treatment (P> 0.05), while Hb levels at 21, 28, 35, 42, 49 and 56 days Were higher than the control group, the differences were statistically significant (P <0.05). After treatment, the levels of CD3, CD4, CD8 and NK cells in the study group were significantly higher than those before treatment, and the CD4 / CD8 values were lower than those before treatment (all P <0.05). The differences between the two groups were statistically significant All were statistically significant (P <0.05). The incidence of grade Ⅰ ~ Ⅱ and grade Ⅲ ~ Ⅳ adverse reactions in the study group was decreased or consistent with that in the control group, with no significant difference (P> 0.05). Conclusion: Integrative Chinese and Western medicine can effectively improve the level of Hb in EPO-antagonized CRA patients, improve the immune function, and reduce the incidence of adverse reactions in the course of treatment.