中西医治疗奥沙利铂诱导的周围神经毒性研究进展  

Research Progress of Treating Oxaliplatin-Induced Peripheral Neuropathy with Traditional Chinese and Western Medicine Treatments

作　　者：张杰翔 李晓红[1] 袁伟琛 谭兆峰 齐元富[2] ZHANG Jiexiang;LI Xiaohong;YUAN Weichen;TAN Zhaofeng;QI Yuanfu(Shandong University of Traditional Chinese Medicine,Jinan,Shandong,China,250014;Affiliated Hospital of Shandong University of Traditional Chinese Medicine,Jinan,Shandong,China,250014)

机构地区：[1]山东中医药大学,山东济南250014 [2]山东中医药大学附属医院,山东济南250014

出　　处：《河南中医》2023年第7期1127-1134,共8页Henan Traditional Chinese Medicine

基　　金：山东省中医药科技项目(2021Q078);山东省保健科技协会科学技术课题项目(SDBJKT20180119)。

摘　　要：奥沙利铂诱导的周围神经毒性(oxaliplatin-induced peripheral neuropathy,OIPN)是一种综合性不良反应,西医治疗方法除基础的甲钴胺和B族维生素外,还包括使用抗抑郁剂、抗氧化剂、乙酰胆碱酯酶(acetylcholinesterase,AChE)抑制剂、神经保护剂等治疗;中医药防治方法包括中医内治法、中医外治法和中医综合疗法等。目前,研究存在的问题是:现代医学药物如抗抑郁剂、抗氧化剂、AChE抑制剂、神经保护剂等可直接作用于靶点治疗,但现阶段上述多种药物并不是直接针对OIPN的,没有可以作为一线治疗的推荐药物,且临床研究样本量少,没有大规模循证医学数据支持,还需要进行作用机制、药理学、毒理学研究;中医对OIPN的治疗从辨证论治角度出发,但中药内治法普及较为困难,中医外治法则需制定专家共识与指南,推广简单有效的中医外治法以减轻患者痛苦、提高患者生存质量。中医综合疗法和中西医结合治疗或为最有效,但如何进行有效创新和理论结合仍是研究难点,需不断进行临床研究,充分发挥中西医结合治疗OIPN的优势。Oxaliplatin-induced peripheral neurotoxicity(OIPN)is a comprehensive adverse reaction.In addition to the basic methylcobalamin and B vitamins,western medicine treatments include the use of antidepressants,antioxidants,acetylcholinesterase(AChE)inhibitors,neuroprotective agents,etc.;TCM prevention and treatments include TCM internal treatments,TCM external treatments,and TCM comprehensive therapy.At present,the problems with relevant research are as follows:Modern medical drugs such as antidepressants,antioxidants,AChE inhibitors,neuroprotective agents,etc.can directly act on targets.However,these most drugs are not directly targeted at OIPN and have not been recommended as first-line treatment drugs.Moreover,the sample size of clinical research is small,and there is no large-scale evidence-based medical data support.Further research on the mechanism of action,pharmacology,and toxicology is needed.The treatment of OIPN in TCM starts from the perspective of syndrome differentiation,but it is difficult to popularize the internal treatments of TCM.Expert consensus and guidelines need to be developed for the external treatments of TCM,promoting simple and effective external methods of TCM to reduce pain and improve the quality of life.TCM comprehensive therapy and integrated traditional Chinese and Western medicine treatment may be the most effective,but effective innovation and theoretical integration are still research difficulties,and continuous clinical research is needed to fully leverage the advantages of integrated traditional Chinese and Western medicine in treating OIPN.

关 键 词：奥沙利铂 周围神经毒性 中西医治疗 中医内治法 中医外治法 

分 类 号：R273[医药卫生—中西医结合]