汤红霞 王梦影 庹婧

[摘要] 目的 探討艾迪注射液联合VAD化疗方案治疗多发性骨髓瘤（MM）患者的效果及安全性。 方法 收集2015年1月～2018年1月四川省内江市中医医院收治的60例MM患者，按随机数字表法分为对照组和治疗组，每组各30例。对照组给予VAD化疗方案治疗，治疗组给予艾迪注射液联合VAD化疗方案治疗，4周为1个疗程，两组均连续给予治疗3个疗程。评价并比较两组临床疗效，检测并比较两组治疗前后血清M蛋白、β2-微球蛋白水平、血红蛋白含量、骨髓瘤细胞含量和外周血CD3+、CD4+及CD8+水平。记录并比较两组患者治疗过程中不良反应的发生情况。 结果 治疗组总有效率高于对照组，差异有统计学意义（P < 0.05）。治疗后，两组M蛋白、β2-微球蛋白及骨髓瘤细胞含量均明显低于治疗前，血红蛋白含量均明显高于治疗前，且治疗组M蛋白、β2-微球蛋白、血红蛋白及骨髓瘤细胞含量的变化幅度均明显大于对照组，差异均有统计学意义（P < 0.05）。治疗后，治疗组外周血CD3+、CD4+水平均明显高于治疗前，外周血CD8+水平明显低于治疗前，且治疗组外周血CD3+、CD4+水平明显高于对照组，外周血CD8+水平明显低于对照组，差异均有统计学意义（P < 0.05）。治疗过程中，两组不良反应发生率比较差异无统计学意义（P > 0.05）。 结论 艾迪注射液联合VAD化疗方案治疗MM的临床效果显著，能够明显提高患者的免疫功能，且安全性较好，值得在临床上推广应用。

[关键词] 多发性骨髓瘤；艾迪注射液；VAD化疗方案；疗效；安全性

[中图分类号] R733 [文献标识码] A [文章编号] 1673-7210（2018）09（a）-0067-05

[Abstract] Objective To study the clinical efficacy and safety of Aidi Injection combined with VAD chemotherapy program in patients with multiple myeloma （MM）. Methods A total of 60 patients with MM admitted to Neijiang Traditional Chinese Medicine Hospital of Sichuan Province from January 2015 to January 2018 were enrolled in this study. The subjects were divided into the control group and the treatment group according to the random number table method， with 30 cases in each group. The control group was treated with VAD chemotherapy program， the treatment group was treated with Aidi Injection combined with VAD chemotherapy program. Four weeks were a course of treatment， the two groups were treated for 3 courses. The clinical efficacy of the two groups were evaluated and compared. The serum M protein， β2-microglobulin， hemoglobin， myeloma cells and peripheral blood CD3+，CD4+，CD8+of the two groups before and after treatment were compared. The adverse reactions of the two groups during the treatment were recorded and compared. Results The total effective rate of the treatment group was higher than that of the control group， the difference was statistically significant （P < 0.05）. After treatment， the M protein， β2-microglobulin and the content of myeloma cells of the two groups were significantly less than those before treatment （P < 0.05）， the hemoglobin content was significantly greater than those before treatment （P < 0.05）， and the changes in the treatment group were significantly greater than those in the control group （P < 0.05）. After treatment， the levels of CD3+， CD4+ in peripheral blood of the treatment group were significantly higher than those before treatment （P < 0.05）， while the level of CD8+ in peripheral blood of the treatment group was significantly lower than that before treatment （P < 0.05）， and the levels of CD3+， CD4+ in peripheral blood of the treatment group were significantly higher than those of control group， while the level of CD8+ in peripheral blood of the treatment group was significantly lower than that of control group （P < 0.05）. There was no significant difference of the adverse reactions between the two groups during the treatment （P > 0.05）. Conclusion Aidi Injection combined with VAD chemotherapy program in patients with MM has good efficacy and safety， which can also improve the immune function of patients. It is worthy of clinical promotion and application.

[Key words] Multiple myeloma； Aidi Injection； VAD chemotherapy program； Efficacy； Safety

多发性骨髓瘤（multiple myeloma，MM）是一种临床常见的血液系统肿瘤，属于浆细胞恶性增殖性疾病，好发于老年人群，具有较高的发病率和病死率[1]。目前，临床治疗MM主要采用化疗手段，其中VAD化疗是基层应用最为广泛的治疗方案，具有较好的疗效，能够改善患者的临床症状，提高患者生活质量，延长生存期，然而化疗会引起胃肠道反应、骨髓抑制、免疫抑制等副作用，患者依从性较差[2-3]。因此，在化疗过程中提高患者的机体免疫功能，减轻毒副作用，对于MM的治疗具有重要的临床意义。……