Objectives of Study:
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To observe the efficacy and safety of moxibustion with seed-sized moxa cone combined with traditional Chinese and western medicine in the treatment of senile acute myeloid leukemia. It provides a new method and scheme for the clinical treatment of AML in the elderly, lays a foundation for the treatment of other types of leukemia, and gives full play to the characteristics and advantages of traditional moxibustion in the treatment of difficult serious diseases.
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Description for medicine or protocol of treatment in detail:
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On the basis of conventional Chinese and western medicine treatment, the enrolled patients were given wheat moxibustion treatment. For specific chemotherapy regimen selection, TCM syndrome differentiation and TCM prescription, refer to the Expert Consensus on the Diagnosis and Treatment of Integrated Chinese and Western Medicine in Elderly acute myeloid Leukemia (non-acute promyelocytic Leukemia) (2019).
Basic treatment
(1)Chemotherapy of western medicine: use low-intensity chemotherapy. The specific plan is as follows:
① Azacitidine [75mg / (m2 d) 7d];
② Decitabine [20mg / (m2 d) 5d];
③ Decitabine combined with small-dose chemotherapy;
④ Low-dose chemotherapy ± G-CSF: low-dose cytarabine (Ara-C) -based CAG and CMG (C: Ara-C; A: arubicin (Acla); G: granulocyte colony stimulating factor (G-CSF); M: mitoxantrone); ⑤ low-dose Ara-C: 20mg twice a day, continuously for 10d, 1 course for 4 to 6 weeks. ⑥ The Bcl-2 inhibitor
(2) Symptomatic treatment of western medicine: in the process of chemotherapy, antivomiting, stomach protection, liver protection and other symptomatic support treatment. When HGB 60g / L; when PLT 20109 / L, give hemostatic drugs and apheresis platelets; when coinfection, when granulocyte deficiency is more than 7 days.
TCM treatment: according to TCM diagnosis, TCM decoction, 1 dose daily, 200ml each; after chemotherapy, 1 pill / day oral.
Moxibustion with seed-sized moxa cone treatment:
Main point:Dazhui Ke shu Pi' shu Shen shu Tsusanli
Matching acupoint:Chungwan (Nausea, vomiting patient) Qihai Guan yuan(Weak person) San yin chiao(Poor sleep3 or 5 Zhuang).
Moxibustion treatment began from 3 days before chemotherapy, with 5 zhuang per point of Dazu and nephroshu, and 7 zhuang per point. The dose of moxibustion could be adjusted according to the condition of the patient's tolerance.According to the patient's symptoms can also choose the corresponding acupoint, once a day, rest 1-2 days a week.A total of 4 weeks of treatment was performed.Suggestions: after the end of the course and discharge, patients should adhere to their own moxibustion, moxibustion daily or interval to consolidate the curative effect.
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