目的回顾性分析中西医个体化分层治疗老年急性髓系白血病(AML)的临床疗效和不良反应。方法采用回顾性研究方法,根据患者合并的基础疾病、体力状态(ECOG)评分、治疗方法将54例老年AML患者分为A组(扶正祛邪方加减+标准剂量化疗组,19例)、B组(扶正祛邪方加减+减低剂量化疗组,18例)、C组(扶正祛邪方加减姑息治疗组,17例),分析患者骨髓缓解率、生存时间、中医证候疗效和不良反应。结果54例患者缓解率为68.5%(37/54),平均生存时间为(12.9±6.0)个月,中位生存时间为13个月,1年及以上生存率为55.6%(30/54),中医证候总有效率为83.3%(45/54),患者出现感染、胃肠道反应、心脏毒性、肝肾毒性的发生率分别为25.9%(14/54)、16.7%(9/54)、11.1%(6/54)、7.4%(4/54)。除中医证候疗效外,C组其余指标均低于A、B组(P<0.05)。结论中西医个体化分层方案可提高老年AML临床疗效,减少不良反应的发生,提高生存质量,增加远期疗效。 Objective To retrospectively analyze the clinical efficacy and side effects of individualized and stratified treatment of acute and chronic myelogenous leukemia (AML) with traditional Chinese and western medicine. Methods A retrospective study was conducted to divide 54 elderly patients with AML into A group (19 cases) treated with Fuzheng Quxiefang plus / minus standard chemotherapy, according to the patients’ basic diseases and physical condition (ECOG) scores and treatment methods. Group B (Fuzheng Quxie Fang addition and subtraction + dose reduction chemotherapy group, 18 cases), C group (Fuzheng Quxie Fang addition and subtraction palliative treatment group, 17 cases), analysis of patients with bone marrow remission rate, survival time, TCM Syndrome and Adverse reactions. Results The response rate of 54 patients was 68.5% (37/54). The mean survival time was (12.9 ± 6.0) months. The median survival time was 13 months. The survival rates at 1 year and over were 55.6% (30/54) The total effective rate of TCM syndromes was 83.3% (45/54). The incidence of infection, gastrointestinal reaction, cardiotoxicity and hepatorenal toxicity were 25.9% (14/54) and 16.7% (9/54) ), 11.1% (6/54), 7.4% (4/54). Except curative effect of traditional Chinese medicine syndromes, the remaining indexes of group C were lower than those of group A and B (P <0.05). Conclusion The individualized stratification program of Chinese and Western medicine can improve the clinical efficacy of elderly AML, reduce the incidence of adverse reactions, improve the quality of life and increase long-term efficacy.