【摘要】 目的评估帕米膦酸二钠联合鲑鱼降钙素、骨化三醇胶丸治疗多发性骨髓瘤(MM)骨痛的疗效。方法选择2011年3月至2013年9月天津市第四中心医院血液肿瘤科收治的具有骨痛伴/不伴病理性骨折的MM患者47例,按照双盲、随机的方法分两组:研究组(24例)应用三药联合治疗,帕米膦酸二钠90 mg静脉滴注1次,鲑鱼降钙素50 U隔日肌内注射,连续1个月,骨化三醇胶丸0.25μg,每日1次口服,连续1个月。对照组(23例)仅用帕米膦酸二钠治疗,同研究组。分别于治疗前、治疗后14 d和28 d对两组患者疼痛数字评价量表(NRS)、生活质量量表(QOL)、Karnafshy评分(KPS)进行评估。结果治疗后14、28 d,两组患者的NRS均呈下降趋势,且研究组对应时间点下降幅度大于对照组,差异有统计学意义(P<0.05);治疗后14、28 d,两组患者的QOL、KPS均呈升高趋势,且研究组对应时间点高于对照组,差异有统计学意义(P<0.05)。治疗后14 d,研究组总缓解率为91.7%(22/24),显著高于对照组的65.2%(15/23),差异有统计学意义(P<0.05);治疗后28 d,研究组总缓解率为91.7%(22/24),显著高于对照组的43.5%(10/23),差异有统计学意义(P<0.05)。结论应用帕米膦酸二钠联合鲑鱼降钙素、骨化三醇胶丸治疗MM骨痛效果可靠,具有积极的临床意义。更多还原

【Abstract】 Objective To evaluate the efficacy of pamidronate combined with miacalcic and rocaltrol treating multiple myeloma( MM). Methods Total of 47 patients with ostealgia with or without pathologic fracture admitted to Tianjin Fourth Central Hospital from Mar. 2011 to Sep. 2013 were divided into study group( 24 patients) and control group( 23 patients) according to a randomized double-blind method. The study group was treated with pamidronate( 90 mg intravenous in one month),miacalcic( 50 U intramuscular injection once every two days in one month) and rocaltrol( 0. 25 μg per os every day in one month),and the control group was treated with only pamidronate( 90 mg intravenous in one month). NRS,QOL,KPS were compared at pretherapy,day 14 and 28 after therapy in the two groups. Results The NRS was decreased in both groups at posttreatment,and the study group declined more than the control group at the same time point,with significant difference( P < 0. 05). The QOL and KPS tended to rise at posttreatment,and the study group rose more than the control group at the same time point,with significant difference( P < 0. 05).At the 14 th day after treatment,the total remission rate in study group( 91. 7%,22 /24) was higher than the control group( 65. 2%,15 /23),with significant difference( P < 0. 05). At the 28 th day after treatment,the total remission rate in the study group( 91. 7%,22 /24) was higher than that in control group( 43. 5%,10 /23),with significant difference( P < 0. 05). Conclusion A good response is expected to treat MM ostealgia by pamidronate,miacalcic and rocaltrol,which is of positive clinical significance.更多还原