Clinical Observation On The Treatment Of Multiple Myeloma Bone Disease And Intervention Study Of DKK1mRNA Expression With Yishen Huoxue Qingsui Prescription

Objective:To observe the clinical efficacy of Yishen Huoxue Qingsui Prescription combined with bortezomib-based regimen on the treatment of multiple myeloma bone disease with kidney deficiency and blood stasis,and to preliminarily explore its intervention on DKK1 m RNA expression level.In order to find the evidence that can improve the osteolytic destruction of MBD from the aspect of traditional Chinese medicine,and provide a new approach for clinical diagnosis and treatment.Methods:30 patients with multiple myeloma bone disease of the kidney deficiency and blood stasis type were collected and randomly divided into two groups:observation Group（15 cases）and control group（15 cases）.The control group was treated with bortezomib-based regimen.The observation group was treated with Yishen Huoxue Qingsui Prescription on the basis of the control group.After 4 months of treatment,the clinical efficacy of the two groups was observed,and real-time fluorescence quantitative PCR technique was applied to detect the DKK1 m RNA expression level in peripheral blood before and after treatment。Results:1.The efficacy of TCM syndrome:After treatment,the TCM syndrome scores of the two groups of patients were lower than before treatment,and the TCM syndrome score of the observation group was lower than that of the control group,and the total effective rate of the observation group（93.3%）was higher than that of the control group（53.3%）.The differences were statistically significant（P<0.05）.2.Western medicine clinical efficacy:the ORR of the observation group（86.7%）was higher than the ORR of the control group（80.0%）,but the difference was not statistically significant（P>0.05）.3.Bone pain intensity score:After treatment,the NRS pain scores of the two groups were improved.The total effective rate of the observation group（93.3%）was higher than that of the control group（73.3%）.The differences were statistically significant（P<0.05）.4.Quality of life score:observation group:improvement:66.7%,stability:26.7%,decrease:6.7%;control group:improvement:20.0%,stability:66.7%,decrease:13.3%.After treatment,the quality of life of the two groups of patients was improved,and the improvement of the observation group was more obvious than that of the control group,and the difference was statistically significant（P<0.05）.5.Tumor load index:after treatment,the ratio of bone marrow plasma cells and M protein decreased in both groups compared with those before treatment,and those of the observation group were lower than the control group,the differences were statistically significant（P<0.05）.The difference ofβ₂-MG between the two groups before and after treatment was not statistically significant（P>0.05）.6.Bone metabolic markers:after treatment,PINP in the two groups was higher than before treatment,CTX in the two groups was lower than before treatment,and the difference in the observation group was more significant than that in the control group（p<0.05）.7.Safety index:HGB increased in both groups after treatment,increase in the observation group was higher than that in the control group,the difference was statistically significant（P<0.05）;the differences in PLT,ALT,AST,SCr and BUN between the two groups before and after treatment were not statistically significant（P>0.05）.8.The level of DKK1 m RNA in peripheral blood:after treatment,the level of DKK1 m RNA in peripheral blood of the two groups decreased significantly compared with that before treatment,and the degree of decrease was more obvious in the observation group than in the control group.All the differences were statistically significant（P<0.05）.Conclusion:Yishen Huoxue Qingsui Prescription combined with bortezomib-based regimen can effectively improve the TCM symptoms,bone pain,tumor load,bone metabolic index and anemia symptoms of MBD patients with kidney deficiency and blood stasis type,and improve the quality of life of patients,furthermore,it is involved in regulating DKK1-related pathway in MBD pathological mechanism and reducing the expression level of DKK1 m RNA in peripheral blood.