Observation Of Therapeutic Effect Of Bushen Huoxue Huayu Recipe Combined With Chemotherapy On Renal Damage Of Myeloma

Background:Multiple myeloma originates from the terminal differentiation stage of B cells and is a monoclonal proliferative tumor of plasma cells.The malignant proliferation of a large number of monoclonal immunoglobulins and light chains,resulting in damage to the related target organs,is the main pathogenesis of MM.The main clinical manifestations include CRAB symptoms of hypercalcemia,bone destruction,anemia and renal damage.Acute renal impairment of the complications of MM is an important risk factor for early death of MM patients^[1].About 10%-40%in MM patients found varying degrees of renal damage,25%-50%patients have various degrees of renal injury during the entire course of the myeloma,10%of the patients with severe renal damage need renal replacement therapy.Most patients with MM renal damage have a median survival of less than 2 years.The probability of complete recovery of renal function in the first 3 months of MM was 50%-70%,and the probability of renal damage reversal for more than 3 months was only 10%^[4],in contrast,the survival time of the former is significantly higher than the latter.How to treat patients with early renal impairment as early as possible is beneficial to early relief of renal damage,to reduce the incidence of end-stage renal disease,and to improve the survival rate.MM belongs to the category of"bone arthralgia"in traditional Chinese Medicine.Combined with kidney deficiency is the main physiological basis of elderly patients with myeloma,traditional Chinese medicine believes that the pathogenesis of MM kidney disease is kidney essence deficiency,deficiency of bone marrow blight pathogen infection,blood stasis,blood stasis.Treatment should be treated with invigorating kidney and activating blood and removing stasis.According to many years of clinical experience of Professor Qiu Heming's old professor,our department formed a clinical and effective recipe for invigorating kidney and activating blood and removing blood stasis.Composition:shudihuang15g,huaishanyao15g,buguzhi15g,tusizi20g,danggui15g,taoren15g,honghua5g,sanqi10g.This study is to further clarify the clinical effect of Bushen Huoxue Huayu Recipe on early renal dysfunction,and provide new ideas for the treatment of MM kidney damage by traditional Chinese medicine.Methods:By using the prospective study method,selection of the First Affiliated Hospital of Guangzhou University of Chinese Medicine,Department of Hematology hospital patients,consistent with the requirements of MM diagnostic criteria,42 patients with elevated serum creatinine,were randomly divided into experimental group and control group,21 cases in each group.The patients in the experimental group were treated with Bushen Huoxue Huayu Recipe Combined with chemotherapy,while the control group was treated with chemotherapy alone without TCM intervention.The treatment course lasted for 2 months,and the relevant laboratory indicators were observed after each course to evaluate the curative effect.Observation of renal function indexes such as eGFR,ACR,creatinine,urinary albumin,24 hours urinary protein,urinary bladder SS C,serum beta 2 microglobulin and laboratory examination and treatment of TCM syndrome integral and curative effect after treatment,using SPSS20.0statistical data analysis,as P<0.05 was statistically significant.Results:1.The renal function related indexes of the experimental group,including serum creatinine,eGFR,24hpro,ACR,microalbuminuria,serum C and serum beta 2 microglobulin,were significantly improved compared with the control group?P<0.05?,with statistical significance.2.The score of TCM syndrome in the experimental group was significantly lower than that in the control group?P<0.05?,with statistical significance.3.In the effect of primary disease,there was no significant difference between the experimental group and the control group?P>0.05?,and there was no statistical difference.Conclusion:Bushen Huoxue Huayu Recipe Combined with chemotherapy is helpful to improve renal damage caused by multiple myeloma,and the earlier use of Bushen Huoxue Huayu Recipe is more effective.The combined chemotherapy of invigorating kidney and activating blood circulation and removing stasis has clinical significance on the decline of TCM syndrome score,but there is no statistical significance in evaluating the curative effect of the original disease.