含奥沙利铂或紫杉醇化疗方案所致周围神经毒性的影响因素及扶正健脾汤联合甲钴胺预防作用分析  

Protective effects of Fuzheng Jianpi Decoction combined with mecobalamin on chemotherapy-induced peripheral neurotoxicity with oxaliplatin or paclitaxel and analysis of influencing factors of these neurotoxicity

作　　者：潘守杰 杨宁娟 马瑞 朱正秋 PAN Shoujie;YANG Ningjuan;MA Rui;ZHU Zhengqiu(Xuzhou Medical University,Xuzhou,Jiangsu 221006;Department of Oncology,Lianyungang Hospital of Traditional Chinese Medicine,Lianyungang,Jiangsu 222000;不详)

机构地区：[1]徐州医科大学,江苏徐州221006 [2]江苏省连云港市中医院肿瘤科,江苏连云港222000 [3]徐州医科大学附属医院肿瘤科,江苏徐州221006

出　　处：《河北中医》2021年第9期1504-1508,共5页Hebei Journal of Traditional Chinese Medicine

基　　金：江苏省中医药管理局项目(编号:YB201837)。

摘　　要：目的观察扶正健脾汤联合甲钴胺对含奥沙利铂或紫杉醇方案化疗所致周围神经毒性的防治作用,并采用多因素Logistic回归分析化疗所致周围神经毒性的影响因素。方法将120例采用奥沙利铂或紫杉醇化疗方案治疗的消化系统恶性肿瘤患者按照随机数字表简单随机分为2组。对照组60例采用含奥沙利铂或紫杉醇方案化疗,治疗组60例在化疗同时给予扶正健脾汤联合甲钴胺预防治疗。观察2组周围神经毒性分级,并对发生周围神经毒性的患者随访12个月,比较随访1、3、6、12个月时周围神经毒性缓解情况。采用多因素Logistic回归分析化疗所致周围神经毒性的影响因素。结果治疗组周围神经毒性分级明显低于对照组(P<0.05)。治疗组随访6、12个月时周围神经毒性缓解率分别为70.59%(12/17)、94.12(16/17),对照组分别为40.48%(17/42)、61.90%(26/42),治疗组均高于对照组同期(P<0.05)。多因素Logistic回归分析显示,奥沙利铂累积剂量>1600 mg、紫杉醇累积剂量>1200 mg、肝功能损伤及扶正健脾汤+甲钴胺治疗均为周围神经毒性的相关影响因素(P<0.05)。结论化疗药物累积剂量和肝功能损伤均为化疗导致周围神经毒性的相关影响因素,采取扶正健脾汤联合甲钴胺预防含奥沙利铂或紫杉醇化疗方案所致周围神经毒性效果明显,可有效降低发生率,加速神经毒性缓解。Objective To observe protective effects of Fuzheng Jianpi Decoction combined with mecobalamin on chemotherapy-induced peripheral neurotoxicity(PN)with oxaliplatin(OXA)or paclitaxel(PTX),and to analyze the influencing factors of these neurotoxicity by multivariate Logistic regression analysis.Methods Toally 120 patients with digestive system malignant tumor undergoing chemotherapy(OXA or PTX)were divided into equal group according to the random number table,on the basis of chemotherapy with OXA or PTX,and treatment group received Fuzheng Jianpi Decoction combined with mecobalamin.PN classification was counted;1-year follow-up was carried out to compare follow-up remission rate of PN on month 1,month 3,month 6,month 12 posttreatment;multivariate Logistic regression was used to analyze influencing factors of chemotherapy-induced PN.Results PN classification in treatment group was significantly lower than that in control group(P<0.05).The follow-up PN remission rate on month 6,month 12 posttreatment was higher in treatment group than in control group[70.59%(12/17)vs 40.48%(17/42),94.12(16/17)vs 61.90%(26/42),(P<0.05),respectively].Multivariate Logistic regression analysis showed that the relevant influencing factors for PN was cumulative dose of OXA>1600 mg,cumulative dose of PTX>1200 mg,liver function damage,and Fuzheng Jianpi Decoction combined with mecobalamin therapy(P<0.05).Conclusion Cumulative doses of chemotherapy drugs and liver function damage are associated with influencing factors of chemotherapy-induced PN.Fuzheng Jianpi Decoction combined with mecobalamin has effective on chemotherapy-induced PN with OXA or PTX,which can reduce the incidence and accelerate the remission of neurotoxicity.

关 键 词：抗肿瘤联合化疗方案 药物相关性副作用和不良反应 周围神经毒性 影响因素分析 扶正 健脾 中西医结合疗法 

分 类 号：R730.53[医药卫生—肿瘤]