通络散治疗化疗后周围神经损伤及对神经传导的影响  

Treatment of peripheralnerve injury after chemotherapy with Tong-luo powder and its effect on nerve conduction

作　　者：刘娜 丁丽佳 孙文博 刘爱 孟双双 孙谦 LIU Na;DING Li-jia;SUN Wen-bo;LIU Ai;MENG Shuang-shuang;SUN Qian(Hengshui Hospital of Traditional Chinese Medicine,Hengshui 053000,China;Hengshui Third People′s Hospital,Hengshui 053099,China)

机构地区：[1]河北省衡水市中医医院,河北衡水053000 [2]河北省衡水市第三人民医院,河北衡水053099

出　　处：《实用医院临床杂志》2023年第5期147-152,共6页Practical Journal of Clinical Medicine

基　　金：衡水市重点研发计划项目(编号:2022014044Z)。

摘　　要：目的 探究通络散治疗化疗后周围神经损伤及对运动神经传导速度(MCV)、感觉神经传导速度(SCV)水平的影响。方法 选取2020年10月至2022年10月我院110例化疗后周围神经损伤患者,随机数字表法分为研究组和对照组各55例。对照组给予常规西药(甲钴胺)治疗,研究组在对照组用药基础上给予自拟通络散治疗,均治疗2月。比较两组治疗效果、中医证候积分、正中神经和腓肠神经运动神经传导速度(MCV)、感觉神经传导速度(SCV)、血清炎性因子[C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)、白介素-8(IL-8)]、周围神经损伤相关因子[纤维凝胶蛋白-3、网膜素-1、成纤维细胞生长因子21(FGF21)]、总神经病变评分(TNS)、生存质量评分(KPS)及不良反应。结果 治疗2个月后研究组总有效率高于对照组(P<0.05);治疗1、2个月后研究组肢体麻木、疼痛、畏寒肢冷、神疲乏力评分、TNS评分较对照组低,KPS评分高于对照组,正中神经和腓肠神经MCV、SCV均高于对照组(P<0.05);血清CRP、TNF-α、IL-8、FGF21水平低于对照组,纤维凝胶蛋白-3、网膜素-1水平高于对照组(P<0.05)。结论 通络散可改善化疗后周围神经损伤患者周围神经病变程度、神经传导速度,还可提高患者生活质量、降低炎性反应。Objective To explore the treatment of peripheral nerve injury after chemotherapy with Tong-luo powder and its effect on the levels of motor nerve conduction velocity(MCV)and sensory nerve conduction velocity(SCV).A total of 110 patients with peripheral nerve injury after chemotherapy in our hospital from October 2020 to October 2022 were selected.The patients were divided into a study group and a control group according to random number table method,55 in each group.The control group was treated with conventional western medicine(mecobalamine),and the study group was treated with self-designed Tong-luo powder on the basis of the control group.The therapeutic effect,TCM syndrome score,MCV and SCV of median nerve and sural nerve,serum inflammatory factors such as C-reactive protein(CRP),tumor necrosis factor-α(TNF-α),interleukin-8(IL-8),peripheral nerve injury-related factors such as ficolin-3,omentin-1 and fibroblast growth factor 21(FGF21),total neuropathy score(TNS),quality of life(KPS score)and adverse reactions were compared between the two groups.After 2 months of treatment,the total effective rate of the study group was higher than that of the control group(P<0.05).After 2 months of treatment,the scores of limb numbness,pain,chills,fatigue and TNS score in the study group were lower than those in the control group while KPS score in the study group were higher than that in the control group(P<0.05).After 1 month and 2 months of treatment,the MCV and SCV of median nerve and sural nerve in the study group were faster than those in the control group(P<0.05).The levels of serum CRP,TNF-α,IL-8 and FGF21 in the study group were lower than those in the control group while the levels of ficolin-3 and omentin-1 were higher than those in the control group(P<0.05).Tong-luo powder can improve the degree of peripheral neuropathy and nerve conduction velocity in patients with peripheral nerve injury after chemotherapy.It can also improve the quality of life and reduce the inflammatory response of these patients.

关 键 词：通络散 化疗 周围神经损伤 运动神经传导速度 感觉神经传导速度 

分 类 号：R74[医药卫生—神经病学与精神病学]