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目的观察吉西他滨联合环磷酸胺和氟达拉滨治疗非霍奇金淋巴瘤的临床疗效和安全性。方法 64例非霍奇金淋巴瘤患者随机均分为试验组和对照组,每组32例。对照组静脉滴注吉西他滨1000 mg·m~(-2),静脉滴注30 min,每周1次,连续3周,根据患者的药物不良反应相应减少剂量。试验组在对照组的基础上静脉滴注氟达拉滨25 mg·m~(-2),环磷酰胺15 mg·m~(-2),静脉滴注30min,连用5 d。2组均每4周为1个周期,共治疗3个周期。比较2组患者的临床疗效、体能状态评分、疼痛程度及药物不良反应发生情况。结果治疗后,试验组总有效率为96.88%(31/32例),对照组为78.13%(27/32例),差异有统计学意义(P<0.05)。试验组患者治疗前后Kamofsky评分分别为(58.69±4.13),(86.88±3.48)分,差异有统计学意义(P<0.05)。治疗后,试验组和对照组患者的视觉模拟评分(VAS)分别为(1.44±1.21),(4.13±1.36)分,差异有统计学意义(P<0.05)。试验组出现白细胞、血小板减少4例,过敏3例,恶心1例,药物不良反应率为25.00%(8/32例);对照组出现白细胞、血小板减少7例,过敏5例,恶心3例,药物不良反应发生率为46.88%(15/32例),差异有统计学意义(P<0.05)。结论吉西他滨联合环磷酸胺和氟达拉滨治疗非霍奇金淋巴瘤的临床疗效优于单独使用吉西他滨方案,能明显改善患者的体能状态,缓解患者的疼痛。
Objective To observe the clinical efficacy and safety of gemcitabine plus cyclophosphamide and fludarabine in the treatment of non-Hodgkin’s lymphoma. Methods 64 cases of non-Hodgkin’s lymphoma were randomly divided into experimental group and control group, 32 cases in each group. The control group was injected with gemcitabine 1000 mg · m -2 intravenously for 30 min once a week for 3 consecutive weeks. The dose of gemcitabine was reduced according to the adverse drug reactions of the patients. On the basis of the control group, the experimental group received intravenous infusion of fludarabine 25 mg · m -2 and cyclophosphamide 15 mg · m -2 for 30 min. 2 groups were every 4 weeks for a cycle, a total of 3 cycles. The clinical efficacy, physical status score, pain level and adverse drug reactions in two groups were compared. Results After treatment, the total effective rate was 96.88% (31/32 cases) in the experimental group and 78.13% (27/32 cases) in the control group, the difference was statistically significant (P <0.05). The Kamofsky scores before and after treatment in the test group were (58.69 ± 4.13) and (86.88 ± 3.48) points, respectively, with significant difference (P <0.05). After treatment, the visual analogue scale (VAS) of test group and control group were (1.44 ± 1.21) and (4.13 ± 1.36) points respectively, the difference was statistically significant (P <0.05). Leukocytes were found in the experimental group, 4 cases of thrombocytopenia, 3 cases of allergy, 1 case of nausea and 1 case of nausea and 25.00% of drug adverse reactions (8/32 cases). Leukocytes, thrombocytopenia in 7 cases, allergy in 5 cases, nausea in 3 cases, Adverse drug reaction rate was 46.88% (15/32 cases), the difference was statistically significant (P <0.05). Conclusion The clinical efficacy of gemcitabine combined with cyclophosphamide and fludarabine in the treatment of non-Hodgkin’s lymphoma is better than that of gemcitabine alone. It can significantly improve the patient’s physical condition and relieve the patient’s pain.