养血温经通络中药泡洗防治草酸铂所致神经毒性54例临床观察  

Clinical Observation on 54 Cases of Oxaliplatin Induced Neurotoxicity Treated with Soaking and Washing Therapy with Nurishing-Blood,Warming-Channels and Dredging-Collaterals

作　　者：唐武军[1] 信彬[1] 邓超[1] 王笑民[1] 杨国旺[1] 张青[1] 杨中[1] 张萃[1] 

机构地区：[1]首都医科大学附属北京中医医院

出　　处：《中医杂志》2014年第23期2007-2010,共4页Journal of Traditional Chinese Medicine

基　　金：北京市中医药科技项目(JJ2009-33)

摘　　要：目的观察养血温经通络中药泡洗防治草酸铂所致神经毒性的临床疗效及安全性。方法将128例接受草酸铂化疗的患者随机分为治疗组和对照组各64例。对照组给予单纯化疗,共6~8周期,治疗组化疗同时给予养血温经通络中药泡洗,每日早晚各1次,中药泡洗从化疗第1天开始使用直至化疗结束。观察两组患者周围神经毒性的发生率及程度、多伦多临床评分系统(TCSS)评分、出现Ⅱ度及以上神经毒性所用草酸铂的累积剂量及不良反应。结果治疗组周围神经毒性的发生率为59.26%,对照组为78.43%;Ⅱ度及以上周围神经毒性的发生率治疗组为12.96%,对照组为37.25%,治疗组均明显低于对照组(P<0.05)。治疗组TCSS评分明显低于对照组(P<0.05)。两组发生Ⅱ度及以上神经毒性草酸铂累积量、血液学毒性发生率差异均无统计学意义(P>0.05)。结论养血温经通络中药泡洗可以降低草酸铂所致周围神经毒性的发生率和分级水平,且不良反应少。Objective To observe clinical efficay and safety of soaking and washing with Chinese medicinals of nurishing the blood, warming channels and dredging collaterals as prevention and treatment for oxaliplatin induced neurotoxicity. Methods Totally 128 patients who underwent oxaliplatin chemotherapy were randomly divided into treatment group and control group, each including 64 patients. Mere chemotherapy was given to the control group, from 6 to 8 cycles, whereas soaking and washing in Chinese medicinals with the effects of nurishing the blood, war- ming channels and dredging collaterals were given along chemotherapy in the treatment group in the morning and at night from day 1 to the end of chemotherapy. We observed the incidence and degree of peripheral neurotoxicity, Toronto Clinical Scoring System （TCSS）, adverse effects and the accumulated dose of oxaliplatin when neurotoxicity of degree U or above occurred. Results Incidence of peripheral neurotoxicity was 59.26% in the treatment group, while 78.43% in the control group. Incidence of degree H peripheral neurotoxicity or above was 12.96% in the treatment group, significantly lower than 37.25% in the control group （P 〈 0. 05 ）. TCSS of the treatment group was significantly lower than that of the control group （P 〈 0. 05 ）. The difference of accumulated dose of oxaliplatin when neurotoxicity＇of degree Ⅱ or above occurred and incidence of blood toxicity between two groups suggested no statistical significance （P 〉 0.05 ）. Conclusion Soaking and washing in Chinese medicinals with the effects of nurishing the blood, warming channels and dredging collaterals can reduce the incidence and degree of peripheral neurotoxicity caused by oxaliplatin, with low occurrence of adverse effects.

关 键 词：养血温经通络 中药泡洗 草酸铂 神经毒性 

分 类 号：R273[医药卫生—中西医结合]