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目的探讨沙利度胺联合VAD方案(长春新碱+阿霉素+地塞米松)治疗多发性骨髓瘤(Multiple myeloma,MM)的临床疗效及相关不良反应。方法选取2010.01-2016.01于内蒙古医科大学附属医院确诊的多发性骨髓瘤患者随机分为实验组(n=24)与对照组(n=26),实验组采用沙利度胺加VAD方案化疗(长春新碱+阿霉素+地塞米松),对照组单纯用VAD标准方案,4个疗程后对患者的临床疗效及不良反应进行评价,并进行对比。结果实验组总有效率为79.2%,明显优于对照组的61.5%(P<0.05),两组患者在治疗后浆细胞,M蛋白,β2微球蛋白,血清碱性磷酸酶(ALP)都降低,实验组疗效更明显(0.05),实验组血红蛋白上升相对于对照组更为显著(P<0.05)。结论应用沙利度胺联合VAD方案的多发性骨髓瘤患者具有不良反应少、耐受性好、给药方便、疗效明显的优点,值得进一步深入研究及临床推广应用。
Objective To investigate the clinical efficacy and related adverse reactions of thalidomide combined with VAD regimen (vincristine + doxorubicin + dexamethasone) in the treatment of multiple myeloma (MM). Methods The patients with multiple myeloma diagnosed in the Affiliated Hospital of Inner Mongolia Medical University from January 2010 to June 2016 were randomly divided into experimental group (n = 24) and control group (n = 26). The experimental group was treated with thalidomide plus VAD regimen (Changchun Neoadjuvant + doxorubicin + dexamethasone). The control group was treated with VAD standard regimen only. After 4 courses of treatment, the clinical efficacy and adverse reactions of the patients were evaluated and compared. Results The total effective rate was 79.2% in the experimental group, which was significantly better than 61.5% in the control group (P <0.05). After treatment, plasma cells, M protein, β2 microglobulin and serum alkaline phosphatase (ALP) (0.05). The increase of hemoglobin in the experimental group was more significant than that in the control group (P <0.05). Conclusions Patients with multiple myeloma treated with thalidomide combined with VAD have the advantages of less adverse reactions, better tolerability, convenient administration and obvious curative effect, which deserves further study and clinical application.