A Retrospective Study On The Treatment Of Senile Acute Myeloid Leukemia With Integrated Traditional Chinese And Western Medicine

BackgroundAcute myeloid leukemia(AML)is a group of clinical malignancies caused by abnormal proliferation of myeloid leukemia cells,in which the elderly patients?60 years old account for more than 50%of adult myeloid leukemia.However,due to the poor basic conditions,unique pathophysiological characteristics,increased gene instability,increased drug resistance genes and other factors,the elderly AML patients lead to poor clinical efficacy,short survival,increased adverse reactions to chemotherapy and other practical problems.The elderly AML is relatively young patients with conservative treatment,alternative treatment options and drugs also decreased significantly compared with adult patients,so how to patients in clinical individualized,selecting rational treatment,effectively reduce the patients'clinical adverse events occur,prolong patient survival,improve the quality of survival is a problem which needs to be settled.The participation of traditional Chinese medicine can improve the basic constitution of patients to a certain extent,enhance the therapeutic effect,reduce the occurrence of clinical adverse events,so as to prolong the survival period of patients,improve the quality of life and prognosis of patients.ObjectiveThrough summarizing the clinical data analysis combine traditional Chinese and western medicine in the treatment of elderly patients with acute myeloid leukemia median survival period,at the same time to explore the clinical commonly used indicators,the relationship between TCM syndrome type and survival,definite the related factors influencing the patients' survival,for how to reduce the occurrence of adverse events in the clinical treatment,prolong survival,etc to provide certain clinical basis.MethodsThe clinical data of 59 elderly patients with AML were reviewed and observed.SPSS 20.0 was used to analyze the relationship between clinical basic data,TCM symptoms and survival time of patients.ResultsAmong 59 patients,26 were treated with traditional Chinese medicine combined with chemotherapy,and 33 were treated with traditional Chinese medicine alone.By the end of observation,20 patients with chemotherapy had died and 6 survived.All the patients in the non-chemotherapy group died,including 24 patients died in hospital and 9 patients died outside hospital.According to the analysis of the existing data,the results showed that the chromosome mutation,white blood cell level,red blood cell and platelet transfusion volume of the patients with the deficiency of Qi and blood were significantly higher than those with the deficiency of Qi and blood(P<0.05),while the hemoglobin level of the patients with the deficiency of Qi and blood was significantly higher than that of the patients with the deficiency of Qi and blood(P<0.05).In terms of survival time,the median survival time of low-intensity chemotherapy combined with traditional Chinese medicine patients?75 years old group was 13 months,and the median survival time of>patients 75 years old group was 6 months.WT1 gene mutation,age?75 years old,no chemotherapy,ECOG score ? 3 points,no remission after four courses of treatment,average red blood cell infusion volume>0.2U/d,ISH-DIC score?4 or 5,abnormal D dimer in the first hospitalization,previous coagulation disease,and the total number of complicated diseases?4 could significantly reduce the survival time of the patients(P<0.05).Conclusion1.Low-dose chemotherapy and demethylation therapy can improve the survival of patients,so we should try our best to gain the opportunity of chemotherapy and strengthen supportive treatment.2.The hemoglobin and platelet of the syndrome are lower and more dependent on blood products,and the survival time of patients who rely on blood products is significantly reduced.Therefore,for patients with the syndrome,more active use of supportive treatment should be taken,with the help of traditional Chinese medicine to remove pathogenic factors and strengthen the principles of health.3.The higher the risk of bleeding,the shorter the survival period of patients.Therefore,attention should be paid to clinical identification,regular detection of coagulation indicators,and timely intervention to reduce the occurrence of DIC and bleeding events in patients.4.There is a certain relationship between genetics and TCM syndromes,which also affects the survival of patients.Therefore,further exploration of the relationship between genetics and TCM syndromes is of great significance for better understanding the mechanism of TCM syndromes and improving the survival of patients.