四藤一仙汤熏洗预防奥沙利铂所致周围神经毒性的临床观察  

Clinical Observation on Preventive Effect of Oxiliplatin Induced Peripheral Neuropathy by Fumigation of Siteng Yixian Decoction

作　　者：姜靖雯[1] 陈学武[1] 蔡红兵[2] 王琳[3] 符英金[1] 罗荣城[2] 

机构地区：[1]海南省中医院肿瘤科,海南海口570203 [2]南方医科大学中西医结合医院,广东广州510000 [3]海南省人民医院肿瘤内科,海南海口570311

出　　处：《南京中医药大学学报》2015年第5期420-423,共4页Journal of Nanjing University of Traditional Chinese Medicine

基　　金：海南省自然科学基金(SQ2014ZRJJ0136)

摘　　要：目的观察四藤一仙汤熏洗对奥沙利铂所致周围神经毒性的预防作用。方法选择需要接受含奥沙利铂方案化疗的结直肠癌患者150例,随机分为2组,每组75例。预防治疗组在接受化疗同时采用四藤一仙汤熏洗手足,每次40min,每日2次;对照组只接受化疗,2组患者均至少接受2个疗程化疗。化疗结束后1月评估其周围神经毒性发生及分级情况,评价其预防作用。结果预防治疗组、对照组周围神经毒性发生率分别为18.7%和56.0%,差异显著(P<0.01);预防治疗组和对照组周围神经毒性分级的平均秩次分别是60.63和90.37,预防治疗组周围神经毒性的分级明显低于对照组,有统计学意义(P<0.05);在发生2级及以上周围神经毒性的患者中,预防治疗组和对照组患者奥沙利铂累积剂量分别是1 054.76±124.6,823.47±190.67,差异具有统计学意义(P<0.05);Logisitic回归分析发现,中药熏洗是周围神经毒性发生的保护因素。结论四藤一仙汤熏洗可以降低奥沙利铂所致周围神经毒性发生率、减轻其发生的严重程度,提高患者耐受奥沙利铂化疗累积量,且是周围神经毒性发生的独立保护因素。OBJECTIVE To observe the preventive effect of oxaliplatin induced peripheral neuropathy treated by fumigation of Siteng Yixian decoction.METHODS Totally 150 colorectal cancer patients from oncology department Of Hainan provincial hospital of TCM between January 2010 and December 2014 were enrolled in this study.And they were randomized into two groupswith 75 cases in each.The patients in the control group only received oxaliplatin based chemotherapy.While the pa-tients in the treatment group were given the chemotherapy combined with fumigation of Siteng Yixian decoction.The fumiga-tion lasted for forty minutes a timetwice a day.After the treatment of two cycles chemotherapythe incidence rate and sever-ity classification of peripheral neuropathy was analyzed one month later to evaluate the preventive effect.RESULTS The difference of incidence rate of peripheral neuropathy was significantwith the rate being 18.7% in the treatment group and 56. 0% in the control groupP 〈0.01.The severity classification was evidently higher in the control group90.37than those in the treatment group60.63and there exised a statistical significanceP 〈0.05.Among the patients who had second degree peripheral neuropathy or abovethe oxaliplatin accumulative dose was1 054.76±124.6in the treatment group and823.47 ±190.67 in the control groupand the difference was statistically significantP〈0.05.Logistic regression indicated that fu-migation of Siteng Yixian decoction was the protective factor for the oxaliplatin？induced peripheral neuropathy.CONCLUSION Fumigation of Siteng Yixian decoction can reduce the incidence ratedecline the severity classification of oxaliplatin？induced peripheral neuropathy and increase the oxaliplatin tolerance dose.It is the independent preventive factor for oxaliplatin？induced peripheral neuropathy.

关 键 词：四藤一仙汤 周围神经毒性 奥沙利铂 熏洗 

分 类 号：R273[医药卫生—中西医结合]