Kidney And Blood Side To Reduce The Clinical Studies Of Chemotherapy Hematologic Toxicity

The author here presented her theoretical and primary clinical studies on the treatment of chemotherapy-followed hematology toxicity reaction with Bushen Shengxue Fang.In the part of theoretical study,the paper presented and analyzed the opinions of TCM about the etiology, pathogenesis,therapeutic principles and prescriptions of chemotherapy-followed blood cell decrease.It also summarized the general situation of the research on the chemotherapy-followed bone marrow depression especially in the near 10 years.Chemotherapy-followed blood cell decrease belongs to Weakness and Blood Deficiency in TCM.We think that its pathological mechanism mainly resulting from deficiency of spleen and kidney and stagnation of blood stasis,therefore the therapy principle is tonifying the kidney and invigorating the spleen,nourishing the blood and promoting blood circulation.In the part of clinical study,36 patients with the cancer needed chemotherapy were divided into test group and control group randomly.Test group was treated with Bushen Shengxue Fang (Decoction of Tonifying the Kidney and Hemogenesis),one week before, during and one week after chemotherapy.Control group was treated with Granulocyte colony stimulating factor (G-CSF),3-7 days, once leucocytes dropped bellow 3000×109/L after chemotherapy. The result shows:①The total scores of TCM symptoms grades.The test group of which 10 cases recovered,accounting for 27.78%,and excellence cases were 16,accounting for 44.44%,the effective cases was 8 case,accounting for 22.22%,while the numbers of ineffectiveness were 2 cases, accounting for 5.56%, in which the total rates of effective were 94.44%.Three cases of the control group were recovered,accounting for 8.33%,7 cases were excellence,accounting for 19.44%,8 cases were effective,accounting for 22.22%,while 18 cases were ineffectiveness, accounting for 50%,in which the total rates of effective were 50%,respectively.The effective rate of test group on TCM symptom was significantly higher than that of on control group (P<0.001).②The main TCM individual symptoms were weak, anorexia,abdominal distention after eating, hot sensation in the five hearts,dim complexion. All of these symptoms of the test group were obviously improved(P<0.05),but the difference of dizziness and tinnitus and nocturia more between before and after treatment had no statistically significant (P>0.05),At the same time,the control group made no significant difference after treatment(P>0.05),While there was a significant difference(P<0.05)between the test group and the control group,after treatment.③After chemotherapy,The means of WBC and GRAN in test group were obviously higher than control group on the 7th,10th and 15thafter chemotherapy (P<0.05).The changes of Hb and PLT in these two groups had no obviously difference before and after the chemotherapy (P>0.05).④Score of Karnofsky performance status(KPS).The median of KPS scores of these two groups after chemotherapy were 80 scores (the test group) and 60 scores (the control group), respectively.25 cases of KPS scores in Test Group were improved (69.44%),6 cases were stable(16.67%),5 cases were decreased(13.89%),and the effective rate was 69.44%.While 10 cases of control group were improved (27.78%),10 cases were stable (27.78%),16 cases were decreased (44.44%),and the effective rate was 27.78%.It was validated by Wilcoxon nonparametric test that the treated group gain superior in KPS(P<0.001).⑤The degree of chemotherapy-followed hematology toxicity reaction.the cases of the patients in test group developed hematology toxicity reaction was 25(69.44%),of which the number ofⅠdegree was 22 cases,while the number ofⅡdegree was 3 cases,and none of the patients developed III / IV degree,the incidence rate of hematology toxicity reaction was 69.44%.While 32 cases of control group developed to hematology toxicity reaction (88.89%).of which the number ofⅠdegree was 24 cases, the number ofⅡdegree was 8 cases, the number ofⅢdegree was 4 cases, the number ofⅣdegree was none,the totle incidence rate of hematology toxicity reaction was 88.89%.The degree of hematology toxicity reaction occurrence in test group was significantly lower than that of in control group (P<0.05).⑥As for side-effects after the chemotherapy.The cases of leukopenia and neutropenia between these two groups were significant difference (P>0.05) while hemoglobin Decrease,thrombocytopenia, nausea and vomiting,liver and kidney function lesion between these two groups had no significant difference (P>0.05).⑦Factor analysis make it clear that the main clinical manifestations are lack of vitality,lassitude,loss of appetite,abdominal distention,dizziness,tinnitus,dim complexion and so on,which clue to the pivotal pathogenesis of chemotherapy-followed blood cell decrease on insufficiency of spleen and kidney and stagnation of blood stasis just as inspection of tongue and pulse taking do.⑧Analysed by multiple linear regression,we can inspect that chemotherapy-followed hematology toxicity reaction is positive linear correlation with TNM grade and whether or not has received the treatment of chemotherapy and radiotherapy,furthermore,TNM grade engender maximal influence to chemotherapy-followed hematology toxicity reaction.Conclusion:①Bushen Shengxue Fang effective in preventing and alleviating chemotherapy-followed neutropenia and leukopenia.②Bushen Shengxue Fang could effectually alleviate TCM clinical symptoms, improve physical condition of patients,and improve quality of life for patients suffering from cancer chemotherapy-followed blood cell decrease③Bushen Shengxue Fang has a better clinical safety.