Clinical Observation On The Treatment Of Multiple Myeloma And The Intervention Of CRM1 Expression With Bushen Huoxue Prescription

Objective:To observe the clinical efficacy of Bushen Huoxue decoction combined with chemotherapy in the treatment of multiple myeloma with kidney deficiency and blood stasis,and to preliminarily discuss its intervention effect on the expression of CRM1,so as to provide new ideas for treatment and the research development of multiple myeloma.Methods:Bone marrow from 40 patients with multiple myeloma and 10 healthy adults were collected.The patients were randomly divided into two groups according to the order of treatment,the control group(20 cases)and the observation group(20 cases).The control group was treated with VD chemotherapy,and the observation group was treated with Bushen Huoxue Decoction Combined with VD chemotherapy.After 4 cycles of treatment,the efficacy of the two groups was observed,and real-time fluorescence quantitative PCR technology was used to detect the CRM1 mRNA expression level of bone marrow mononuclear cells of the patients before and after treatment,and the CRM1 mRNA expression level of bone marrow mononuclear cells of the normal control group.Results:1.In terms of total clinical efficacy,the total effective rate ofthe observation group(90%)was higher than that of the control group(75%)(P>0.05);2.In terms of the efficacy of TCM syndromes,after treatment,the TCM syndrome score in the observation group was significantly lower than that in the control grou p(P<0.05),and the total effective rate in the observation group(90%)was significantly higher than that in the control group(75%)(P<0.05).3.In terms of hemoglobin,the hemoglobin levels of patients in both groups were significantly increased after treatment(P<0.05),and the increase was greater in the observation group than in the control group(P<0.05).4.In terms of renal function,blood creatinine and urea nitrogen in both groups decreased significantly after treatment(P<0.05),and the decrease was more obvious in the observation group(P<0.05).5.In terms of quality of life,KPS scores of patients in the two groups were improved after treatment,while those in the control group were improved in 8 cases(40%),stabilized in 8 cases(40%),and decreased in 4 cases(20%).In the observation group,15 cases(75%)were improved,4 cases(20%)were stabilized,and 1 case(5%)was decreased.By rank-sum test,P<0.05,the difference was significant.6.Side effects:There were 5 cases of peripheral neuropathy in the control group during the treatment.incidence is 25%,4 cases of Ⅰ level,1 case of Ⅱ level.There were 2 cases of peripheral neuropathy in theobservation group during the treatment,incidence was 10%,1 case of Ⅰ level,1 case of Ⅱ level;7.CRM1 gene expression:before treatment,the CRM1 mRNA expression level of patients with multiple myeloma was significantly higher than that of normal people,and the difference was statistically significant(p<0.05).After treatment,the CRM1 mRNA expression level of patients in both groups was significantly decreased(p<0.05),the observation group was significantly lower than the control group(P>0.05).Conclusion:Treating multiple myeloma with bushen huoxue decoction combined with VD chemotherapy can significantly improve the symptoms of patients,reduce the toxic and side effects of chemotherapy,and improve the quality of life,with better efficacy than chemotherapy alone.In addition,it has certain intervention effect on the expression of bone marrow CRM1 to improve the clinical remission rate.