Clinical Study Of Jiedushengsui Decoction In The Treatment Of Medium And High-risk Myelodysplastic Syndrome

Objective: Myelodysplastic syndrome(MDS)is a malignant clonal hematological disorder driven by progressive acquired somatic mutations in hematopoietic stem cells(HSCs)with clinical signs of anemia,fever,infection and bleeding tendencies due to the presence of one or more pathological lineages of hematopoiesis in the bone marrow.MDS is a recognized refractory malignant hematological disease with a high risk of leukemic transformation,but there is still a lack of specific therapeutic means,and Chinese medicine interventions are increasingly valued and recognized for their good efficacy.This study was conducted to observe and evaluate the clinical efficacy of Jiedushengsui decoction combined with decitabine in the treatment of patients with medium and high-risk MDS,and to explore the potential value of combined Chinese and Western medical therapy in the treatment of MDS.Methods: Through the method of clinical trial,50 patients were divided into treatment group and control group by random number table method,25 patients in each group.The treatment group was treated with a combination of Chinese and Western medicine,and the control group was treated with Western medicine alone,and the efficacy was evaluated after 4 cycles of treatment.Contents: Fifty patients attending the Weifang Hospital of Traditional Chinese Medicine Oncology Center with IPSS-R higher risk(medium risk,high risk,very high risk)MDS were selected and divided into treatment and control groups according to the random number table method,with 25 patients in each group.The control group was treated with decitabine demethylation alone,and the treatment group was treated with Jiedushengsui decoction on top of it.After completing 4 cycles of treatment,the total effective rate,Western medicine evaluation index,Chinese medicine evidence score,bleeding,hemorrhage and infection,quality of life KPS score and adverse reactions of the two groups were evaluated and comparatively analyzed to explore the clinical efficacy of Jiedushengsui decoction in the treatment of medium and high-risk MDS.Results: Baseline data such as age,gender,disease typing,risk stratification,blood count,and bone marrow primitive cell ratio at the time of enrollment were not statistically different between the two groups by statistical tests and were comparable(P>0.05).After 4 cycles of treatment,no statistical difference was observed in the total effective rate between the two groups(P>0.05).In terms of specific efficacy indicators,patients in the treatment group showed statistically significant differences in the absolute neutrophil and hemoglobin values compared with the control group(P<0.05),while the improvement in platelet count and bone marrow primitive cell ratio was not significant between the two groups(P>0.05).The treatment group had a significant improvement in the TCM syndrome score and TCM syndrome efficacy compared with the control group(P<0.05).In terms of complications,there was a statistically significant difference in the reduction of red blood cell infusion in the treatment group compared with the control group(P<0.05),and there was no statistically significant difference in bleeding and infection(P>0.05).In terms of safety,Jiedushengsui decoction performed well,with milder adverse reactions occurring in both groups,with no statistically significant differences by statistical tests(P>0.05).Conclusion: This clinical study confirms that Jiedushengsui decoction can significantly improve the clinical symptoms of patients with medium and high-risk MDS,improve hematopoietic status and quality of life to a certain extent,with low treatment cost,easy administration,and no significant adverse effects and good tolerability,reflecting the advantages of combined application of Chinese and Western medicine in the treatment of MDS,and providing a reference for the Chinese medicine treatment of patients with medium and high-risk MDS.