目的 探讨复方皂矾丸联合注射用阿扎胞苷治疗骨髓增生异常综合征的临床疗效。方法 选取青岛市第八人民医院在2023年2月—2025年1月收治的骨髓增生异常综合征患者，共计68例。将所有患者按随机数字表法分为对照组和治疗组，每组34例。对照组皮下注射注射用阿扎胞苷75 mg/m²，1次/d。治疗组在对照组基础上口服复方皂矾丸，9丸/次，3次/d。4周为1个治疗周期，两组患者持续治疗6个周期。比较两组治疗效果、红细胞和血小板的输注总量、生活质量、血细胞参数、血清炎症指标。结果 治疗后，对照组的总有效率为55.88%，治疗组的总有效率为79.41%，组间比较差异显著（P＜0.05）。治疗组红细胞、血小板输注总量均明显高于对照组（P＜0.05）。两组治疗后世界卫生组织生存质量量表（WGOQOL-100）评分均显著升高（P＜0.05），治疗组治疗后的WGOQOL-100评分均高于对照组（P＜0.05）。两组治疗后的中性粒细胞、白细胞计数、血红蛋白、血小板计数均明显升高（P＜0.05），治疗组治疗后中性粒细胞、白细胞计数、血红蛋白、血小板计数高于对照组（P＜0.05）。两组治疗后的血清T细胞免疫球蛋白黏蛋白分子-3（Tim3）、低氧诱导因子-1α（HIF-1α）、基质细胞衍生因子-1（SDF-1）水平均明显降低（P＜0.05），且治疗组治疗后血清Tim3、HIF-1α、SDF-1水平明显低于对照组（P＜0.05）。结论 复方皂矾丸联合注射用阿扎胞苷治可提高骨髓增生异常综合征的疗效，改善血细胞指标，提高患者生活质量，调节造血微环境。

Objective To investigate the clinical efficacy of Compound Zaofan Pills combined with Azacitidine for injection in treatment of myelodysplastic syndrome. Methods A total of 68 patients with myelodysplastic syndrome admitted to Qingdao Eighth People's Hospital from February 2023 to January 2025 were selected. All patients were divided into control group and treatment group with random number table method, with 34 cases in each group. The control group received sc Azacitidine for injection 75 mg/m², once daily. The treatment group were po administered with Compound Zaofan Pills on the base of the control group, 9 pills/time, 3 times daily. One course was 4 weeks, and two groups continued to receive treatment for 6 courses. The treatment effects, total transfusion volume of red blood cells and platelets, quality of life, blood cell parameters, and serum inflammatory indicators were compared between two groups. Results After treatment, the total effective rate of the control group was 55.88%, and the total effective rate of the treatment group was 79.41%, with significant differences between the groups (P < 0.05). The total transfusion volume of red blood cells and platelets in the treatment group was significantly higher than that in the control group (P < 0.05). The World Health Organization Quality of Life Scale (WGOQOL-100) scores of two groups significantly increased after treatment (P < 0.05), and the WGOQOL-100 scores of the treatment group were higher than those of the control group after treatment (P < 0.05). After treatment, the neutrophil, white blood cell count, hemoglobin, and platelet count in two groups were significantly increased (P < 0.05). The neutrophil, white blood cell count, hemoglobin, and platelet count in the treatment group were higher than those in the control group after treatment (P < 0.05). After treatment, the serum levels of T cell immunoglobulin mucin molecule-3 (Tim3), hypoxia inducible factor-1α (HIF-1α), and stromal cell-derived factor-1 (SDF-1) in two groups were significantly reduced (P < 0.05), and the serum levels of Tim3, HIF-1α, and SDF-1 in the treatment group were significantly lower than those in the control group (P < 0.05). Conclusion Compound Zaofan Pills combined with Azacitidine for injection can improve therapeutic effect in treatment of myelodysplastic syndrome, improve blood cell indicators, enhance quality of life, and regulate the hematopoietic microenvironment.

R977

济南市卫生局科技计划项目（201820047）