Clinical Study Of Jiawei Xijiao Dihuang Decoction In The Prevention And Treatment Of Acute Myeloid Leukosis Hemorrhage

Objective:To explore the clinical efficacy of jiawei xijiao dihuang decoction combined with standard chemotherapy in the prevention and treatment of acute myeloid leukemia(AML)hemorrhage,and to evaluate the clinical value of jiawei xijiao dihuang decoction in the prevention and treatment of AML bleeding,in order to obtain the objective scientific basis of clinical benefit and explore the objective advantage of combined treatment of traditional Chinese medicine.Methods:This study selected newly diagnosed AML(non-APL)patients who were treated in the Cancer diagnosis and treatment Center of Weifang Hospital of traditional Chinese Medicine from December 2021 to December 2022.Based on the principles required by the clinical observation study,50 patients who met the inclusion and exclusion criteria were randomly divided into treatment group(jiawei xijiao dihuang decoction combined with DA regimen)and control group(DA regimen),with 25 patients in each group.28 days as a course of treatment,a total of 1 course of treatment.During the study period,both groups were treated with routine hematological treatment(liver protection,stomach protection,antiemetic,anti-infection,etc.).If the two groups of patients with obvious bleeding tendency or bleeding in the course of treatment,routine hemostatic treatment should be given.If routine hemostatic therapy is ineffective,antifibrinolytic therapy or thrombolytic therapy is required(such as DIC),which belongs to cases of major changes in the condition,emergency intervention and shedding.All selected cases were collected diagnostic data such as bone marrow image examination,cytogenetic and molecular biology examination,immunophenotypic test,and therapeutic data collection such as bleeding outcome evaluation,symptoms and signs,quality of life score,adverse reactions and so on before treatment.The collected data were inputted into the Excel table,and all the data were processed by SPSS26.0 software package.When P<0.05,it was considered statistically significant.Results:1.General data:statistical analysis showed that there was no statistical difference in age,sex,AML classification,average body surface area and platelet count between the two groups before treatment.2.Bleeding-related outcome:after treatment,there were statistical differences in the incidence of bleeding and the time of the first occurrence of bleeding between the two groups,indicating that jiawei xijiao dihuang decoction could reduce the bleeding tendency of patients and delay the occurrence of bleeding events.However,there was no statistical significance for the improvement of bleeding grade between the treatment group and the control group.In addition,there was no statistical difference in the location of first bleeding and hematological indexes between the two groups.3.Syndrome score of traditional Chinese medicine:the total score and effective rate of TCM syndrome in the treatment group are better than those in the control group,indicating that jiawei xijiao dihuang decoction can effectively relieve the TCM symptoms of AML.4.Quality of life evaluation:after treatment,the KPS score of the two groups was slightly higher than that before treatment,but there was no statistical difference.At the same time,there was no statistical difference in the efficacy evaluation of KPS score between the two groups.5.Adverse reaction:There was no significant difference in the total incidence of adverse reactions between the treatment group and the control group.The incidence of digestive tract reaction in the treatment group was slightly lower than that in the control group,but the incidence of allergic reaction and cardiac function damage in the treatment group was slightly higher than that in the control group.The incidence of liver damage was the same in the two groups,and no case of renal damage was found.Conclusion:1.Jiawei xijiao dihuang decoction combined with DA in the prevention and treatment of AML complicated with bleeding can reduce the bleeding tendency of patients,delay the occurrence time of bleeding,improve patients’TCM syndromes and clinical symptoms with good safety,and has a certain clinical value.The good curative effect of this prescription may be related to the core pathogenesis of AML complicated with bleeding,and most of the selected drugs have hemostatic effect in traditional Chinese medicine,and can prevent and treat patients’ bleeding from multiple angles.And in terms of pharmacological effects,modern pharmacological research results have also confirmed that this prescription can indeed prevent and treat bleeding from different angles,such as increasing platelet count,promoting platelet aggregation,improving blood coagulation and promoting bone marrow hematopoiesis,etc.,which also provides strong evidence for the good curative effect of this prescription on the prevention and treatment of AML hemorrhage.2.Although the effect of jiawei xijiao dihuang decoction on bleeding grade,location of first bleeding,hematological index and quality of life of the patients was slightly different from that of the control group,it was not statistically significant.This may be related to the small sample size,short research time and complex causes of bleeding in this study.At the same time,this prescription is formulated for the prevention and treatment of AML complicated with hemorrhage,but the effect on improving the overall quality of life of patients is limited.