| Hematological malignancy chemotherapy-associated diarrhea refers to patients with hematological malignancies who have sprayed watery stools during or after chemotherapy,which are performed several or dozens of times a day,accompanied by abdominal pain or no symptoms of abdominal pain.More consideration should be given to chemotherapy drugs.As a result,it can last for 5 to 7 days,or even as long as 2 to 3 months[1].Hematological malignancies chemotherapy-related diarrhea is one of the common digestive tract complications during chemotherapy in patients with hematological malignancies[2],it is easy to induce infection,water and electrolyte disorders,hypovolemic shock,etc.,affecting the patient’s physical fitness,quality of life and Follow-up treatment,severe cases will endanger the life of the patient.The motherland medicine has certain advantages in the treatment of malignant hematological diseases and chemotherapy-related diarrhea.Related pathological studies believe that Chinese herbal compound and its active ingredients can regulate the intestinal flora and maintain the balance of intestinal microecology[3].Purpose:Through retrospective research on patients with hematological malignancies related to diarrhea after chemotherapy,analysis of the distribution characteristics of TCM syndromes and medication rules of chemotherapy-associated diarrhea of malignant hematological diseases in our hospital,in order to standardize the related syndromes in the future,and concurrently treat related syndromes.Provide evidence.Method:According to the 2017 edition of "Diarrhea TCM Diarrhea Diagnosis and Treatment Expert Consensus"[4]and clinical research progress of chemotherapy-related diarrhea,the research plan of "Malignant Hematological Chemotherapy-Related Diarrhea TCM Syndrome Type" was developed,and collected from January 2010 to March 2020 During the period,inpatients in the Department of Hematology,Jiangsu Provincial Hospital of Traditional ChineseMedicine,were diagnosed with hematological malignancies(acute leukemia,lymphoma,multiple myeloma),complicated by chemotherapy-related diarrhea.Using the computer electronic medical record system,according to the search results,the relevant hospitalization medical records were consulted one by one,and the relevant objective data were collected according to the diarrhea diagnostic criteria in the above-mentioned research plan.Use Microsoft Excel to establish a case data database,analyze the relevant information of patients,use SPSS 26.0 statistical software to analyze the frequency of malignant hematological diseases and chemotherapy-related diarrhea syndromes,and make relevant analysis charts.Result:A total of 4,068 cases of patients who underwent "chemotherapy" were collected.Among them,3412 were patients with acute leukemia,lymphoma,and multiple myeloma.There were 398 patients with obvious gastrointestinal reactions.Among them,163 patients with diarrhea symptoms were eligible for inclusion.There are 122 standard medical records.1.Analysis of malignant hematological diseases with chemotherapy-related diarrhea:Among 122 cases of hematological malignancies with chemotherapy-related diarrhea,the type of disease was 41.80%(51/122)of multiple bone marrow>31.15%(38/122)of lymphoma>28.69%(35/122)of acute leukemia.2.Analysis of chemotherapy regimens used for chemotherapy-related diarrhea:Among 51 cases of multiple myeloma chemotherapy-related diarrhea,the chemotherapy regimens containing hormones(dexamethasone/prednisone)and bortezomib accounted for the most,accounting for 60.78%(31/51),followed by hormones(prednisone).The chemotherapy regimen of cemethasone/prednisone)and thalidomide/lenalidomide was 27.45%(14/51).Among the 38 cases of lymphoma chemotherapy-related diarrhea,the chemotherapy regimen containing"CHOP"accounted for 36.84%(14/38),followed by Hyper CVAD and the"GCP" regimen,each accounting for 7.89%(3/38);chemotherapy 26 cases of cyclophosphamide>23 cases of dexamethasone/methylprednisolone>15 cases of vindesine>14 cases of rituximab.Among the 35 cases of acute leukemia chemotherapy-related diarrhea,acute myeloid leukemia was most common,accounting for 74.29%(26/35).Among them,the chemotherapy regimens containing "cytarabine" were the most common,with a total of 25 cases,accounting for 71.43%.3.Analysis of TCM Syndrome Types of Chemotherapy-related Diarrhea:Among 122 cases of hematological malignancies with chemotherapy-related diarrhea,the TCM syndrome type was 38.52%(47/122)of deficiency of spleen-qi,28.69%(35/122)of cold-dampness trapping spleen,and 18.03%(22/22)122)>Cold-heat complex syndrome 6.56%(8/122)>Liver-qi multiplying spleen syndrome 5.74%(7/122)>Kidney-yang deficiency syndrome 2.46%(3/122).4.Analysis of traditional Chinese medicine for chemotherapy-related diarrhea:Among them,there are 89 cases of using Chinese medicine and Chinese medicine,accounting for 72.95%.The drugs with a frequency of use of Chinese medicine greater than 10 were Poria 47.52%(48/101),Atractylodes 34.65%(35/101),Tangerine peel 34.65%(35/101),Astragalus 32.67%(33/101),and Baishao 26.73%(27/101),dried/pao ginger 25.74%(26/101),coix seed 24.75%(25/101),fried atractylodes 22.77%(23/101),fried grain bud 21.78%(22/101),pinellia 19.80%(20/101),Codonopsis 19.80%(20/101),Scutellaria baicalensis 18.81%(19/101),Coptis 17.82%(18/101),Yam 15.84%(16/101),Magnolia officinalis 14.85%(15/101),woody 14.85%(15/101),schisandra 13.86%(14/101),lentil flower 12.87%(13/101).in conclusion:Diarrhea associated with chemotherapy for malignant hematological diseases often occurs in multiple myeloma,containing bortezomib,thalidomide/lenalidomide,hormones(dexamethasone/prednisone/methylprednisolone),Phosphoramide,vindesine,rituximab,and cytarabine are the most common chemotherapy regimens.In traditional Chinese medicine,chemotherapy-related diarrhea associated with malignant hematological diseases is often based on deficiency of spleen qi,while cold-dampness trapping the spleen syndrome and intestinal damp-heat syndrome are more common;in traditional Chinese medicine,chemotherapy-related diarrhea related to malignant hematological diseases is mostly used to invigorate the spleen and eliminate dampness.(Poria,Atractylodes/Stir-fried Atractylodes,Coix Seed,Lentil Flower),Spleen and Qi Replenishing Medicine(Astragalus,Codonopsis,Chinese Yam),Qi and Stomach Medicine(Tangerine Peel,Muxiang,Fried Grain Sprout,Magnolia),to clear away heat and dampness Medicines(pinellia,scutellaria,coptis),warm Chinese medicine(dry/pao ginger)are more common,and are consistent with the TCM syndrome type. |
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