【摘要】 目的 探讨中药联合RVD(来那度胺、硼替佐米、地塞米松)方案在多发性骨髓瘤(MM)序贯治疗中的应用效果。方法 选取2020年1月—2024年2月武威市人民医院收治的经病理检查确诊为初发MM患者63例，根据治疗方法不同分为研究组(中药联合RVD方案治疗)33例和对照组(RVD方案治疗)30例。比较两组的临床疗效、中医证候积分、血液学指标及不良反应。结果 治疗4周期后，研究组总有效率为90.9%高于对照组的70.0%；两组中医证候积分均较治疗前降低，且研究组低于对照组；两组血红蛋白水平均较治疗前升高，而肌酐、β2微球蛋白、乳酸脱氢酶水平和红细胞沉降率(ESR)较治疗前下降或减慢；研究组血红蛋白水平高于对照组，肌酐、β2微球蛋白、乳酸脱氢酶水平和ESR低于或慢于对照组(P<0.05)。治疗期间，研究组不良反应总发生率低于对照组(P<0.05)。结论 中药联合RVD方案治疗MM能够提高临床疗效，改善患者临床症状，升高血红蛋白水平，降低肌酐、β2微球蛋白、乳酸脱氢酶水平，减慢ESR，并可减少不良反应的发生。更多还原

【Abstract】 Objective To explore the application effect of traditional Chinese medicine combined with RVD(Lenalidomide,Bortezomib, Dexamethasone) regimen in sequential treatment of multiple myeloma(MM). Methods From January 2020 to February 2024, 63 patients with newly diagnosed MM diagnosed by pathological examination in People’s Hospital of Wuwei were selected. According to different treatment methods, they were divided into study group(traditional Chinese medicine combined with RVD regimen treatment) 33 cases and control group(RVD regimen treatment) 30 cases. The clinical efficacy, traditional Chinese medicine syndrome score, hematological indexes and adverse reactions were compared between the two groups. Results After 4 cycles of treatment, the total effective rate of the study group was 90.9% higher than 70.0% of the control group; the traditional Chinese medicine syndrome scores of the two groups were lower than those before treatment, and the study group was lower than the control group; the levels of hemoglobin in the two groups were higher than those before treatment, while the levels of creatinine,β2 microglobulin, lactate dehydrogenase and erythrocyte sedimentation rate(ESR) were lower or slower than those before treatment;the hemoglobin level of the study group was higher than that of the control group, and the levels of creatinine, β2 microglobulin,lactate dehydrogenase and ESR were lower or slower than those of the control group(P < 0.05). During the treatment, the total incidence of adverse reactions in the study group was lower than that in the control group(P < 0.05). Conclusions Traditional Chinese medicine combined with RVD regimen in the treatment of MM can improve the clinical efficacy, improve the clinical symptoms of patients, improve the level of hemoglobin, reduce the levels of creatinine, β2 microglobulin and lactate dehydrogenase,slow down ESR, and reduce the occurrence of adverse reactions.更多还原