ABSTRACT

ABSTRACT

Objective: To analyze effect that Lanzhou prescription and chemotherapy drugs which treat chronic myeloid leukemia by clinical observation, and compare with the group of chemotherapy drugs.

裴正学系列方药的研究

with peripheral blood, bone marrow, and changes in clinical symptoms and signs, to explore Pei Lanzhou side to improve bone marrow hematopoietic function, and improve the effect and mechanism of the clinical symptoms. Its full scientific theoretical basis for the widely used in clinical.

Methods: Thirty patients were randomly grouped into control group (only western chemotherapy) and treatment group (Lanzhou side western medicine chemotherapy). Patients were enrolled, age, gender, disease duration, and other general information, there was no significant difference between the 3 months of treatment, clinical observations of patients with blood, bone marrow, as well as clinical symptoms and signs, and two groups of patients to compare the efficacy analysis.

Results: (1) By t-test (p < 0.05), the disappearance time of the treatment group compared with the control group was significantly shortened. The rate of disappearance of the X² test (p < 0.05), indicating that treatment group disappearance rate than the control group also improved significantly.

(2) Before and after treatment, the treatment group and control group, Hb, WBC, the PLT change was no significant difference (p > 0.05).

(3) Before and after treatment, the treatment group compared with the control of malignant bone marrow hyperplasia reduce the two groups was statistically significant (p < 0.05).

Conclusion: This clinical study, that the western drug chemotherapy more advantage of Integrative Medicine to improve the symptoms of chronic myeloid leukemia patients with normal bone marrow hematopoietic function than a simple show that Pei Lanzhou side can enhance the bone marrow of normal hematopoietic function, and for Western chemotherapy, treatment of CML synergy-oriented prescriptions provide a basis for future clinical application.

Keyword: chronic myeloid leukemia

前言

慢性粒细胞白血病（chronic myeloid leukemia, CML），是由于造血干细胞恶性增殖而引起的，以粒系细胞中幼及晚幼阶段异常增生为主要特征的恶性克隆性疾病。其临床特点是外周血白细胞数显著增高并有不成熟性，脾通常明显肿大。本病通常分为慢性期（CP）、加速期（AP）、急变期（BP）。病程缓慢，多数患者因急性变而死亡。CML的年发病率为1/10万，约占成人白血病的15%～20%，发病率随年龄增长而增加，高峰发病年龄为50～60岁，男女比约为1.4:1。在我国该病年发病率0.36/10万，仅次于急性髓系白血病和急性淋巴细胞白血病，居白血病的第三位，并呈逐年上升的趋势。

慢性粒细胞白血病的确切病因至今仍未明确，可能与电离辐射、病毒感染、化学物质、遗传因素、基因或蛋白质变异有关。该病具有特征性的费城（Ph）染色体，即t（9；22）（q34;q11）染色体易位。分子生物学标志是由该染色体易位而形成的bcr-abl融合基因异常改变。近年来，CML的诊断和治疗在以往的基础上有了长足的进展。

裴正学系列方药的研究

"兰州方"是裴正学教授经过多年临床实践经验总结的、是治疗血液系统疾病的有效方剂之一。兰州方以健脾补肾，扶正固本为大法，此外加入马钱子、土大黄、水蛭等清热解毒、活血化瘀药物，使该方熔扶正、祛邪为一炉，以补为主，以攻为辅，攻补兼施。

慢性粒细胞白血病属祖国医学的"虚劳"、"积聚"、"癥瘕"等范畴。中医认为本病的发生主要是因为先天禀赋不足或后天失养而引起肾精亏虚，脏腑失养；外感六淫，内伤七情等引起气血功能紊乱，脏腑功能失调。肝气郁结，气郁日久，则气滞血瘀，瘀血内停，久积成块；饮食失调，过食肥甘酒食，伤及脾胃，脾虚失运，输布津液无权，湿浊内生，凝聚成积，痰气相搏，血流不畅，瘀块内生；起居无常，寒温不调，感受外邪，邪毒入侵，中伤脏腑，伤血及髓，致使气虚血亏，邪与营血相搏结，脉络瘀阻，久而成积，发为本病。邪毒内郁，郁久化热，热熬津血，久而成结；邪毒气血相搏结，滞留不散，交合而成块；邪毒郁之，化热生火，扰及营血，灼伤阳络，迫血妄行。故临床见患者发热、乏力、皮肤瘀斑、齿衄、鼻衄、腹胀或痛，脾或肝、淋巴结肿大等症状。以上病因病机常兼夹并存，交互为患。总之，此病病位在骨髓、血分，涉及五脏六腑，为气血痰食邪毒相互搏结而成，基本病机是正虚邪实，正虚为气、血、阴的不足，邪实为痰、瘀、毒的搏结。

"西医诊断，中医辨证，中药为主，西药为辅"是裴老在三十余年前提出的中西医结合用于临床治疗的学术观点。此观点已经获得国内中西医结合学界的广泛认可，被称为"十六字方针"。此方针不仅对临床工作具有普遍的指导意义，还为当前中医学术的发展提供了新思路。西医诊断是借助现代医学先进的检查手段明确疾病诊断，在西医诊断基础上实施的中医辨证，是在特定条件下的辨证，其准确性得到了很大的提高，西医诊断明确后的中医辨证，自然而然地将西医的微观、局部观、病原观与中医的宏观、整体观、机体反应观相结合，弥补了各自的缺陷，也发挥了各自所长，为下一步的用药提供更为确切的依据。中药为主，西药为辅，突出中医方药的治疗作用，旨在中医发展。必要时采用西药辅助治疗，可进一步提高疗效。

立题依据