蠲痹活络方泡洗联合雷火灸预防奥沙利铂所致外周神经毒性的临床效果  

Clinical effect of Juanbi Huoluo decoction combined with thunder-fire moxibustion in the prevention of oxaliplatin induced peripheral neurotoxicity

作　　者：邢益阳[1] 徐小雨[1] 吴疆[1] 赵景芳[2] 张乐裕 XING Yiyang;XU Xiaoyu;WU Jiang;ZHAO Jingfang;ZHANG Leyu(Department of Oncology,Jiangyin Hospital of Traditional Chinese Medicine,Jiangsu Province,Jiangyin 214400,China;不详)

机构地区：[1]江苏省江阴市中医院肿瘤科,214400 [2]江苏省无锡市中医医院肿瘤科,214000

出　　处：《临床合理用药》2025年第1期4-7,共4页Chinese Journal of Clinical Rational Drug Use

基　　金：江阴市科技创新专项资金(社会发展科技示范项目)(JY0603-A021014-210017-PB)。

摘　　要：目的观察蠲痹活络方泡洗联合雷火灸预防奥沙利铂所致外周神经毒性的临床效果。方法选取2021年1月—2023年1月于江阴市中医院接受含奥沙利铂方案治疗的恶性肿瘤患者70例,按照随机数字表法分为泡洗+雷火灸组(35例)和维生素B_1组(35例)。2组均采用奥沙利铂两药方案化疗,维生素B_1组化疗后予维生素B_1治疗,泡洗+雷火灸组化疗后采用蠲痹活络方泡洗联合雷火灸治疗,2组均治疗4个周期。比较2组外周神经毒性发生率及分级,治疗前后正中神经、左腓总神经、右腓总神经的运动、感觉神经传导速度、Karnofsky评分法(KPS)评分及不良反应。结果泡洗+雷火灸组外周神经毒性总发生率(71.43%)低于维生素B_1组(91.43%),毒性分级程度低于维生素B_1组(P<0.05或P<0.01)。治疗4个周期后,2组正中神经、左腓总神经、右腓总神经的运动、感觉神经传导速度大于治疗前,且泡洗+雷火灸组大于维生素B_1组(P<0.05或P<0.01);维生素B_1组KPS评分低于治疗前,泡洗+雷火灸组KPS评分高于维生素B_1组(P<0.01),泡洗+雷火灸组KPS评分与治疗前比较差异无统计学意义(P>0.05)。泡洗+雷火灸组血液毒性发生率、分级及肝肾功能异常发生率均低于维生素B_1组(P<0.05)。结论蠲痹活络方泡洗联合雷火灸应用于采用奥沙利铂化疗的癌症患者可有效降低外周神经毒性发生率,保护神经功能,提高生存质量,且安全性较高。Objective To observe the clinical effect of Juanbi Huoluo decoction combined with thunder-fire moxibustion in the prevention of oxaliplatin induced peripheral neurotoxicity.Methods Seventy patients with malignant tumors who received oxaliplatin containing regimen in Jiangyin Hospital of Traditional Chinese Medicine from January 2021 to January 2023 were selected and randomly divided into herbal soaking+thunder-fire roasting group(35 cases)and vitamin B 1 group(35 cases).Both groups were treated with oxaliplatin two drug chemotherapy,the vitamin B 1 group was treated with vitamin B 1 after chemotherapy,and the herbal soaking+thunder-fire roasting group was treated with Juanbi Huoluo decoction combined with thunder-fire moxibustion after chemotherapy.Both groups were treated for 4 cycles.The incidence and grading of peripheral neurotoxicity,motor and sensory nerve conduction velocities of median nerve,left common peroneal nerve and right common peroneal nerve,KPS score before and after treatment,and adverse reactions were compared between the two groups.Results The total incidence of peripheral neurotoxicity in the herbal soaking+thunder-fire roasting group(71.43%)was lower than that in the vitamin B 1 group(91.43%),and the degree of toxicity grading was lower than that in the vitamin B 1 group(P<0.05 or P<0.01).After 4 cycles of treatment,the motor and sensory nerve conduction velocities of median nerve,left common peroneal nerve and right common peroneal nerve in the two groups were greater than those before treatment,and those in the herbal soaking+thunder-fire roasting group were greater than those in the vitamin B 1 group(P<0.05 or P<0.01).The KPS score of the vitamin B 1 group was lower than that before treatment,and the KPS score of the herbal soaking+thunder-fire roasting group was higher than that of the vitamin B 1 group(P<0.01).There was no significant difference in the KPS score of the herbal soaking+thunder-fire roasting group compared with that before treatment(P>0.05).The incidence of blood toxicity,

关 键 词：外周神经毒性 奥沙利铂 蠲痹活络方 雷火灸 

分 类 号：R277.7[医药卫生—中医学] R273