消痰通络凝胶联合甲钴胺片治疗化疗诱导性周围神经病变临床研究  

Clinical Observation of Xiaotan Tongluo Gel Combined with Mecobalamin Tablets in Ttreating Peripheral Neurotoxicity Induced by Chemotherapy

作　　者：徐晶钰[1] 张璇 王晓炜[1] 秦志丰[1] 唐继贵[1] 陆烨[1] 魏品康[1] XU Jing-yu;ZHANG Xuan;WANG Xiao-wei;QIN Zhi-feng;TANG Ji-gui;LU Ye;WEI Pin-kang(Department of Traditional Chinese Medicine,Changzheng Hospital,Second Military Medical University,Shanghai 200003,Chin)

机构地区：[1]第二军医大学长征医院中医科,上海200003

出　　处：《中国中医药信息杂志》2018年第7期11-15,共5页Chinese Journal of Information on Traditional Chinese Medicine

基　　金：上海市科委引导项目(14401931300;16401933700);上海长征医院院级课题(2016CZQN14)

摘　　要：目的观察消痰通络凝胶联合甲钴胺片对化疗诱导性周围神经病变(CIPN)的临床疗效。方法采用随机数字表法将67例CIPN患者随机分为治疗组36例及对照组31例。2组均予甲钴胺片,每次0.5 mg,每日3次,口服。治疗组同时予消痰通络凝胶,对照组予安慰剂凝胶,1 mL/cm^2,每日9:00、21:00涂于患者感觉障碍部位,直径大于患处皮肤1 cm。2组均14 d为1个疗程,连续治疗2个疗程。观察2组患者周围神经毒性分级、中医症状积分、周围神经传导速度情况。结果治疗14、28 d,治疗组周围神经毒性症状疗效总有效率分别为75.00%、91.67%,对照组分别为38.71%、67.74%,治疗组明显优于对照组(P=0.002,P=0.005)。治疗14、28 d,治疗组中医疗效总有效率分别为75.00%、94.44%,对照组分别为45.16%、64.52%,治疗组明显优于对照组(P=0.018,P=0.005)。与本组治疗前比较,2组治疗14、28 d中医症状积分明显降低(P<0.01);2组治疗后同一时点比较,治疗组中医症状积分明显低于对照组(P<0.01)。与本组治疗前比较,2组治疗14、28 d腓神经、正中神经的感觉神经和运动神经传导速度明显增强(P<0.01);2组治疗后同一时点比较,治疗组腓神经、正中神经的感觉神经和运动神经传导速度明显优于对照组(P<0.05,P<0.01)。结论消痰通络凝胶联合甲钴胺片可有效改善CIPN患者周围神经毒性症状,改善中医症状,提高周围神经传导速度。Objective To investigate clinical efficacy of Xiaotan Tongluo Gel combined with mecobalamin tablets in treating chemotherapy-induced peripheral neuropathy（CIPN）. Methods Totally 67 cases of CIPN were divided into the treatment group（36 cases） and the control group（31 cases）. Both groups were given mecobalamin tablets, 0.5 mg each time, three times a day, orally. Patients in the treatment group were treated with Xiaotan Tongluo Gel for external use at the same time. The patients in control group were treated with placebo gel for external use, 1 mL/cm^2, rubbed on the skin 1 cm more than sensory obstruction in diameter. The treatment for both groups lasted for 14 d as a treatment course, and the treatment lasted for 2 courses. The changes of peripheral nerve toxicity, TCM syndrome scores and the nerve conduction velocity were observed in the two groups. Results On the 14 th and 28 th days of treatment, the total effective rates of peripheral nerve toxicity were 75.00% and 91.67% in the treatment group, and 38.71% and 67.74% in the control group, and the treatment group was significantly better than those of the control group（P=0.002, P=0.005）; On the 14 th and 28 th days of treatment, the total effective rate of TCM efficacy in the treatment group was 75.00% and 94.44% respectively, and that in the control group was 45.16% and 64.52% respectively, and the treatment group was significantly better than the control group（P=0.018, P=0.005）. Compared with before treatment, the TCM syndrome scores in both groups were significantly reduced on the 14 th and 28 th days（P0.01）; The TCM syndrome scores in the treatment group were significantly lower than those in the control group at the same time points after treatment（P0.01）. Compared with before treatment, the sensory and motor nerve conduction speeds of the peroneal and median nerves in the two groups at 14 th and 28 th days were significantly increased（P0.01）; Comparing the two groups at the same time point after treatment, the sensory and

关 键 词：消痰通络凝胶 化疗诱导性周围神经病变 周围神经毒性 

分 类 号：R277.75[医药卫生—中医学]