Clinical Observation On The Treatment Of Multiple Myeloma Renal Impairment And Intervention Study Of PTENmRNA Expression With Yishen Huoxue Qingsui Prescription

Objective:To observe the curative effect of Yishen Huoxue Qingsui Prescription combined with bortezomib-based regimens on the treatment of multiple myeloma renal impairment with kidney deficiency and blood stasis,and the intervention on PTEN m RNA expression level.The study is expected to broaden the thinking for clinical diagnosis and treatment and new drug research and development.Methods:30 patients with MM renal impairment of the kidney deficiency and blood stasis type were collected and randomly divided into experimental and control groups,with 15 patients in each group.The control group was treated with bortezomib-based regimens.The experimental group was treated with Yishen Huoxue Qingsui Prescription on the basis of the control group.After four courses of treatment,the curative effect was observed,and RT-PCR technique was applied to test the PTEN 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 both groups were lower than before（P<0.05）,and the experimental group was lower than control group（P<0.05）.The total effective rate of the experimental group was higher than control group（93.3%vs.60.0%,P<0.05）.2.Western medicine clinical efficacy:The ORR of the experimental group was higher than control group（80.0%vs.73.3%,P>0.05）.3.Quality of life score:After treatment,the quality of life of both groups was significantly improved（P<0.05）,the quality of life in the experimental group improved more significantly than control group（P<0.05）.4.Tumor load index:After treatment,the ratio of bone marrow plasma cells decreased in both groups compared with those before treatment（P<0.05）,and those of the experimental group were lower than control group（P<0.05）.There was no difference in the levels of M protein andβ₂-MG between the two groups after treatment（P>0.05）.5.Renal function index:After treatment,creatinine and glomerular filtration rate in both groups were significantly lower than before,and the creatinine in the experimental group was lower than control group（P<0.05）.There was no significant difference in glomerular filtration rate between the two groups after treatment（P>0.05）.6.The level of PTEN m RNA in peripheral blood:After treatment,both groups had higher PTEN m RNA expression levels than before（P<0.05）,and the degree of increase was more obvious in the experimental group than control group（P<0.05）.7.Incidence of adverse reactions:There was no adverse reaction that interrupted treatment;The incidence of gastrointestinal reactions in the experimental group was lower than control group（26.7%vs.53.3%,P>0.05）,and the incidence of peripheral neuropathy inerimental group was lower than control group（13.3%vs.20.0%,P>0.05）.Conclusion:Yishen Huoxue Qingsui Prescription combined with bortezomib-based regimens can effectively improve the TCM symptoms.At the same time,it can improve the quality of life of of MM renal impairment patients with kidney deficiency and blood stasis.To some extent,it can improve renal function and reduce the tumor load,and the curative effect is better than that of western medicine alone.Furthermore,it may play a role by participating in the regulation of PTEN-related pathways related to MM renal impairment.