中医药联合甲钴胺对恶性肿瘤奥沙利铂化疗所致周围神经毒性的应用效果  

Application Effect of Traditional Chinese Medicine Combined with Mecobalamine on Peripheral Neurotoxicity Caused by Oxaliplatin Chemotherapy in Malignant Tumors

作　　者：李焕焕 聂志勇[1] 吴涛[1] 袁冬冬 张悦姗 刘文会 LI Huanhuan;NIE Zhiyong;WU Tao;YUAN Dongdong;ZHANG Yueshan;LIU Wenhui(Anyang Cancer Hospital,Henan Anyang 455000,China)

机构地区：[1]河南省安阳市肿瘤医院,河南安阳455000

出　　处：《中医药临床杂志》2024年第1期156-160,共5页Clinical Journal of Traditional Chinese Medicine

基　　金：河南省医学科技攻关计划(联合共建)项目(LHGJ20191289)。

摘　　要：目的:探讨中医药联合甲钴胺对恶性肿瘤奥沙利铂化疗所致周围神经毒性的应用效果。方法:对2020年9月—2022年9月就诊的82例奥沙利铂化疗所致周围神经毒性的恶性肿瘤患者的临床资料进行回顾性分析,将其按照治疗方法的不同分为A组(41例,给予甲钴胺片治疗)和B组(41例,给予黄芪桂枝五物汤加减、甲钴胺片治疗),2组患者均进行为期1个月的治疗后对疗效进行评估。将2组患者周围神经毒性分级,改善情况,中医证候疗效,治疗前后卡诺夫斯凯计分(KPS)、疼痛数字分级评分(NRS)评分,神经传导速度进行比较。结果:治疗后2组患者周围神经毒性分级均有所好转,且B组相较于A组改善效果较好;B组患者神经毒性改善有效率比A组高;B组患者中医证候有效率比A组高;治疗后2组患者NRS评分均比治疗前下降,且B组比A组低;治疗后2组患者正中神经、腓总神经传导速度均比治疗前上升,且B组比A组快,差异均有统计学意义。结论:黄芪桂枝五物汤加减联合甲钴胺片治疗恶性肿瘤奥沙利铂化疗所致周围神经毒性,可使患者周围神经毒性分级与疼痛程度下降,提高周围神经毒性效果与中医证候疗效,改善神经传导速度。Objective:To explore the effect of traditional Chinese medicine combined with methylcobalamin on peripheral nerve toxicity caused by oxaliplatin chemotherapy for malignant tumors.Methods:The clinical data of 82 malignant tumor patients with peripheral nerve toxicity caused by oxaliplatin chemotherapy who were treated from September 2020 to September 2022 were retrospectively analyzed,and they were divided into group A according to different treatment methods(41 cases were treated with methylcobalamin tablets)and Group B(41 cases were treated with modified Huangqi Guizhi Wuwu Decoction and methylcobalamin tablets).The patients in both groups were evaluated for efficacy after a one-month treatment.The peripheral nerve toxicity grading,improvement status,TCM syndrome efficacy,Karnovsky score(KPS),numerical pain rating scale(NRS)score,and nerve conduction velocity before and after treatment were compared between the two groups.Results:After treatment,the peripheral neurotoxicity grades of patients in both groups improved,and the improvement effect of group B was better than that of group A;the effective rate of improvement of neurotoxicity of patients in group B was higher than that of group A;the effective rate of improvement of traditional Chinese medicine syndrome of patients in group B was higher than that of group A;after treatment,the NRS scores of patients in both groups were lower than before treatment,and group B was lower than that of group A;after treatment,the conduction velocities of the median nerve and common peroneal nerve of patients in both groups were higher than those before treatment,and group B was lower than that of group A.group,the differences were statistically significant.Conclusion:Modified Huangqi Guizhi Wuwu Decoction combined with methylcobalamin tablets in the treatment of peripheral neurotoxicity caused by oxaliplatin chemotherapy for malignant tumors can reduce the patient’s peripheral neurotoxicity grade and pain level,and improve the peripheral neurotoxicity effect and TCM syndro

关 键 词：黄芪桂枝五物汤 甲钴胺 恶性肿瘤 奥沙利铂 化疗 周围神经毒性 

分 类 号：R453[医药卫生—治疗学]