自拟通络散改善化疗致周围神经损伤效果及抗炎、调控感觉-运动神经传导、生存质量作用研究  

Study on the Effect of Self-formulated Tongluo San to Improve Peripheral Nerve Injury Caused by Chemotherapy and the Effect of Anti-inflammation,Regulation of Sensory-motor Nerve Conduction and Quality of Survival

作　　者：孙文博 段倩宏 杜春海 SUN Wen-bo;DUAN Qiao-hong;DU Chun-hai(Hengshui Hospital of Traditional Chinese Medicine,Hengshui 053000,China)

机构地区：[1]河北省衡水市中医医院,衡水053000

出　　处：《微循环学杂志》2023年第3期29-35,共7页Chinese Journal of Microcirculation

基　　金：衡水市重点研发计划项目(2022014044Z)。

摘　　要：目的:研究自拟通络散改善化疗致周围神经损伤(CIPN)的效果及对炎症反应、调控感觉-运动神经传导、生存质量的影响。方法:采用单中心前瞻性随机对照试验,选取2020-01-2022-08本院收治的110例CIPN患者作为研究对象,简单随机化法分为两组,各55例。对照组给予常规西医治疗,观察组在此基础上给予自拟通络散。比较两组疗效、神经疼痛视觉模拟评分(VAS)评分、美国癌症治疗功能评价系统神经毒性生活质量量表(FACT/GOG-Ntx)评分、麻木感觉[美国癌症研究所(NCI)神经毒性分级]、炎症反应指标[肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、C反应蛋白(CRP)、白细胞介素-8(IL-8)]、正中神经和腓神经感觉神经传导速度(SCV)、运动神经传导速度(MCV)及不良反应发生情况的差异。结果:观察组总有效率高于对照组(96.36%vs 83.64%,P<0.05);治疗4周、8周后观察组神经疼痛VAS评分、FACT/GOG-Ntx评分低于对照组,NCI神经毒性分级分布优于对照组(P<0.05);TNF-α、IL-6、CRP、IL-8水平低于对照组(P<0.05);SCV_(正中神经)、SCV_(腓神经)、MCV_(正中神经)、MCV_(腓神经)高于对照组(P<0.05);观察组不良反应总发生率低于对照组(3.64%vs 18.18%,P<0.05)。结论:常规西医联合自拟通络散治疗CIPN疗效确切,可有效降低不良反应发生率,提高患者生活质量,可能与抑制炎性因子分泌有关。Objective:To study the effect of self-prepared Tongluo San in the treatment of chemotherapy-induced peripheral neuropathy(CIPN)and its effect on inflammatory response,modulation of sensory-motor nerve conduction,and quality of survival.Method:Using a single-centre prospective randomised controlled trial,110 patients with CIPN admitted to our hospital from January 2020 to August 2022 were selected as the study population and divided into two groups of 55 patients each by simple randomisation.The control group was given conventional western medical treatment,and the observation group was given self-prepared Tongluo San on this basis.The two groups were compared for efficacy,visual analog scoring method(VAS)score for nerve pain,American functional assessment system for cancer therapy neurotoxicity quality of life scale(FACT/GOG-Ntx)score,numbness sensation[American cancer institute(NCI)neurotoxicity classification],inflammatory response[tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),C-reactive protein(CRP),interleukin-8(IL-8)],median and peroneal nerve sensory nerve conduction velocity(SCV),motor nerve conduction velocity(MCV),and adverse effects.Results:The total effective rate of 96.36%in the observation group was higher than that of 83.64%in the control group(P<0.05).The VAS score and FACT/GOG-Ntx score of neuropathic pain in the observation group were lower than those in the control group after 4 and 8 weeks of treatment(P<0.05).The distribution of NCI neurotoxicity grading in the observation group was better than that in the control group after 4 and 8 weeks of treatment(P<0.05).TNF-α,IL-6,CRP and IL-8 were lower in the observation group than those in the control group after 4 and 8 weeks of treatment(P<0.05).The SCV_(median nerve),SCV_(peroneal nerve),MCV_(median nerve),and_(MCV peroneal nerve)were higher in the observation group than those in the control group after 4 and 8 weeks of treatment(P<0.05).The overall incidence of adverse reactions in the observation group was 3.64%lower than that in the con

关 键 词：化疗 周围神经损伤 自拟通络散 神经传导速度 生存质量 神经疼痛 疗效 

分 类 号：R587.1[医药卫生—内分泌]