Clinical Efficacy Of Yishen Huoxue Qingsui Prescription In The Treatment Of Multiple Myeloma And The Intervention Study On HMGB1 Expression

Objective:Patients with multiple myeloma(MM)will be treated with Yishen Huoxue Qingsui formula.By statistically analyzing the clinical indicators,efficacy and HMGB1 expression level of the patient to evaluate the efficacy of combining Chinese and Western medicine in the treatment of multiple myeloma,so as to provide a safe and effective clinical treatment method combining Chinese and Western medicine.Methods : 30 patients with primary MM,identified by TCM as kidney deficiency and blood stasis type,were include.The patients were divided into 2 groups using the random number table method,with 15 cases in each group.The observation group was given bortezomib-based regimen combined with Yishen Huoxue Qingsui Formula,while the control group was given bortezomib-based regimen alone.After 4 courses of treatment,the clinical efficacy indexes and adverse reactions of patients in both groups were observed before and after treatment,and the changes of HMGB1 m RNA expression levels in peripheral blood of patients were monitored.Results:1.General information: 30 cases were proposed to be included in this study,and 30 cases were actually included.The study showed that P>0.05 for the two groups of patients in terms of gender,age,and typing and staging,indicating that the two groups of patients could be observed and compared.2.Clinical efficacy:(1)Both the observation group and the control group could reduce the bone marrow clonal plasma cell ratio,M protein amount,urea nitrogen,blood creatinine,and β2 microglobulinlevels after treatment,and the difference was statistically meaningful(P<0.05);(2)When comparing among two groups,the observation group’s hemoglobin levels,M protein,and bone marrow clonal plasma cell ratio showed higher evidence of improvement than in the control group,and the difference was statistically significant(P<0.05).β2-MG,BUN,and SCr(P>0.05);(3)Clinical efficacy analysis,the observation group had 80% total effective rate(ORR),including 2 complete remission instances(CR),5 very excellent partial remission cases(VGPR),5 partial remission cases(PR),and 3additional cases,whereas the ORR of the control group was 73.3%,including2 CR instances,4 VGPR cases,5 PR cases,and 4 additional cases.The ORR add CR rstes of the observation and control groups were determined by Chisquare test P>0.05,proving that the overal effective rate and CR rate of the two treatment groups were comparable.3.Evaluation of TCM symptoms:(1)Within the two groups,there was a substantial change in the TCM symptoms points following treatment compared to those prior to treatment(P<0.05);(2)Compared among groups,the TCM symptoms points of 4.60 ± 0.83 in the observation group were better than those of 7.87 ± 4.64 in the control group,with statistical differences(P<0.05);(3)Compared among groups,93.33% in the observation group were substantially excelled than 66.67% in the control group(P<0.05).4.Bone pain efficacy:(1)Compared between the two groups after treatment,the NRS bone pain score in the observation group was 2.40±1.06,compared with 3.40±1.24 in the control group(P<0.05);(2)Compared within the two groups,the NRS bone pain score decreased significantly after treatment compared with that before treatment,with statistical differences(P<0.05).5.Quality of life:(1)Comparing between the two groups after treatment,the quality of life score in the observation group was 80.67±10.33 compared with 72.67±10.10 in the control group,the improvement in the observation group was more obvious and with statistical differences(P<0.05);(2)Comparing before and after treatment,both the observation group and the control group’ quslity of life score was significantly improved compared with those before treatment(P<0.05);(3)The quality of life score in the observation group improved rate of 73.33% was significantly higher than that of 33.33% in the control group(P<0.05).6.Safety evaluation: 2 cases of infection,4 cases of gastrointestinal reaction,2 cases of peripheral neuropathy,and 2 cases of herpes zoster in the observation group;5 cases of infection,8 cases of gastrointestinal reaction,8 cases of peripheral neuropathy,and 4 cases of herpes zoster in the control group.There was no statistically significant difference in the occurrence of infection,gastrointestinal reaction and herpes zoster events between the two groups(P>0.05),and the incidence of peripheral neuropathy in the observation group was significantly lower at 13.3%compared with 60.0% in the control group(P<0.05).7.HMGB1 m RNA:(1)Comparing between groups after treatment,the observation group 1.03±0.15 was lower than the control group 1.21±0.19,and the difference was statistically meaningful(P<0.05);(2)Comparing before and after treatment among two group,the degree of decrease of HMGB1 in the observation group was more significant than that in the control group(P<0.05).Conclusion: The combination of Yishen Huoxue Qingsui Precription with bortezomib-based regimen can lower the tumor load,improve the symptoms of anemia,TCM syndrome,and bone pain symptoms in patients with multiple myeloma with kidney deficiency and blood stasis,and can enhance the patients’ quality of life.Intervening in the expression of HMGB1 to regulate the tumor microenvironment and improve the clinical remission rate.