| Myeloproliferative Neoplasm(MPN)is a kind of chronic blood tumor,which is relatively rare,orijinated from the bone marrow hematopoietic stem cells,with a system or system continuous characterized by excessive proliferation of blood cells.Mainly includes the primary thrombocytosis(ET),polycythemia vera(PV),bone marrow fibrosis(PMF)three diseases.Its clinical manifestation is relatively hidden,can be asymptomatic patients,.The majority of patients find the disease,when they have physical examination,abdominal distension caused by splenomegaly or acute cardiac cerebrovascular events.This not only delayed the treatment time,also brought irreparable damage to patients.The main complications are thrombosis and bleeding.MPN could convert to bone marrow failure and have the risk of acute leukemia.This is also the main cause of death of the patient,the focus and difficulty of the treatment.So the MPN treatment is to reduce the blood cells,prevent thrombosis and hemorrhage,inhibit the disease progress toward myelofibrosis,bone marrow failure and leukemia,improving the prognosis of disease,improve the patients quality of life.The modern medicine mainly symptomatic treatment and cytotoxic drugs and immune modulators,targeted therapy,cut the spleen method,etc.Its side effects are obvious.Chinese medicine treatment can effectively improve toxicity and enhance the curative effect of western medicine,and then improve the patients quality of life,prolong life.Purposes:1 with the method of retrospective study explore myeloproliferative neoplasm of TCM syndrome characteristics,comparative analysis,and the differences of the reasonable application of traditional Chinese medicine treatment of ET PV PMF three different diseases to provide objective basis.2 to explore the correlation between different TCM syndromes of MPN and blood and bone marrow,and provides the basis for the precision differentiation of modern TCM.3 to explore the correlation between different TCM syndromes of MPN and prognosis related index,so as to provide ideas for disease of TCM syndrome differentiation and prognosis judgement and preliminary basis.Methods:1 to select patients in January 2001-December 2017 in the hospital and another hospital in the hematology department of ET,PV,PMF patients general were 45cases,41cases,51 patients,a total of 137 cases,retrospective investigation,collect the basic information,TCM diagnostic information data,relevant laboratory and pathological examination.Descriptive statistical methods were used to explore the distribution characteristics of TCM syndromes,and to analyze the distribution characteristics of TCM syndromes of MPN.2 to select patients with complete inspection data as the research object,explore the patients with routine blood(WBC,RBC,HGB,HCT,PLT),blood coagulation examination(PT,APTT,FIB,FIBs,TT,D-dimer),hepatosplenomegaly,and bone marrow pathology(bone marrow smear and biopsy)and JAK2V617F mutation,chromosome karyotype and MPN of the correlation between TCM syndrome type.3 to select patients with complete inspection data as the research object,explore the age(>60 years),the history of blood clots,palpable spleen,high white blood cell count,hemoglobin content,platelet count,abnormal chromosome karyotype and JAK2V617F mutation and other related prognostic indicators and MPN the correlation between TCM syndrome type.SPSS 20.0 software was used for statistical analysis of all data data.For the measurement data of normal distribution and variance,the variance analysis method was used to describe the mean plus or minus standard deviation(plus or minus s).Count data adopts the method of descriptive statistics,chi-square,or is a parametric test,the comparison of multiple sets of sample mean using single factor analysis of variance,data comparison between the two groups using the t test and four table chi-square test.Test standard:P<0.05 was considered statistically significant.The results:1 The basic information and TCM four diagnostic information of the 137 patients are as follows:General information:male and female sex ratio 1.54:1,50-70 years of age highest,30-50 years old.32.12%of patients had complications such as thrombosis and bleeding,and 8.03%of patients had acute cardiac cerebrovascular events as the initial symptom.Distribution of symptoms:symptoms of MPN is given priority to with fatigued spirit and lack of strength,dizziness,head heavy,more than 50%,the highest frequency of occurrence frequency more than 15%of symptoms from high to low are:fatigued spirit and lack of strength,dizziness,head heavy,stomach disease or local lumps,insomnia,heart palpitations and with much dream,face is red red,shortness of breath,complexion,dry mouth,dry throat,chest abdomen bilges full,lazy speech,rather tight,look dull.Tongue image:the tongue is dominated by dark red tongue and weak tongue,followed by red tongue and red tongue.The lingual distribution is higher than that of fat tongue and tooth mark.The coating of the tongue is mostly thin and white,white and greasy.The pulse is mainly composed of string and fine veins,followed by slide and sinus.Syndromes:the MPN syndrome is mainly characterized by qi deficiency syndrome and blood stasis syndrome,followed by blood deficiency syndrome and qi stagnation syndrome.ET,PMF blood deficiency syndrome is relatively more,and PV patients have relatively more qi stagnation syndrome.Compared with ET and PV,PMF has a higher probability of qi deficiency and blood deficiency syndrome,while ET has a higher probability of dampness and heat syndrome and PV.2 Blood elephant bone marrow and TCM syndromes:empirical patients RBC and HCT were the highest,and the deficiency was the lowest.The deficiency of PT,APTT and TT were lower than the empirical evidence,and APTT was lower than the patients with false inclusion syndrome.There was a difference in the degree of bone marrow hyperplasia,and the detection rate of bone marrow biopsy fibrosis was lower than that of false inclusion.WBC,PLT,FIB,FIBs,d-dimer,JAK2V617F mutated positive rate showed no significant difference between the three groups of syndromes,and only 4 patients with deficiency of the syndrome showed karyotype abnormality.3 Prognostic indicators and TCM syndromes:the proportion of patients with advanced age was small,and the proportion of patients with false evidence was low,and the incidence of splenomegaly was higher than that of other two types.The risk of hemoglobin<100g/L was higher than that of the other two types.The risk of platelet count<600 ×109/L was the highest.Conclusions:1 All of the MPN syndromes are characterized by qi deficiency syndrome and blood stasis syndrome,followed by blood deficiency syndrome and qi stagnation syndrome.ET,PMF blood deficiency syndrome is relatively more,and PV patients have relatively more qi stagnation syndrome.In contrast,PMF has a higher probability of deficiency of qi deficiency and blood deficiency syndrome,while ET has a higher probability of dampness and heat syndrome and PV.2 TCM syndrome type in there is a correlation between blood picture,bone marrow,RJBC,HCT,PT,APTT,TT,the degree of bone marrow hyperplasia,bone marrow biopsy fibrosis detection rate in different TCM syndrome types,there is a difference,can be used as MPN of TCM clinical reference index.3 Older age,history of blood clots,palpable spleen,hemoglobin<100 g/L,platelet count<600 x 109/L prognosis related indexes such as,there is a certain correlation between TCM syndrome type and can be used as MPN prognostic reference index of traditional Chinese medicine. |
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