补肾活血法辅助奥沙利铂治疗消化道肿瘤的效果

Clinical efficacy of Bushen Huoxue therapy against peripheral neurotoxicity induced by oxaliplatin

目的观察补肾活血法辅助奥沙利铂治疗消化道肿瘤(胃癌、结直肠癌)效果。方法采用回顾性分析方法,将48例胃癌、结直肠癌患者根据治疗方法分为治疗组和对照组,各24例。两组均为奥沙利铂+卡培他滨方案化疗,同加维生素B6,治疗组同时以补肾活血中药口服。观察4个化疗周期,比较两组周围神经毒性分级变化、卡氏(KPS)评分变化。结果化疗第1、2周期因其发生率低,两组周围神经毒性分级无比较意义。化疗第3周期,治疗组神经毒性发生情况,9例未出现,1级10例,2级5例;对照组神经毒性发生情况,4例未出现,1级9例,2级11例;两组比较差异有统计学意义(P<0.05)。化疗第4周期,治疗组神经毒性发生情况,5例未出现,1级11例,2级7例,3级1例;对照组神经毒性发生情况,3例未出现,1级6例,2级9例,3级6例,两组比较差异有统计学意义(P<0.05)。治疗结束后,治疗组KPS评分升至77.5(70.0,87.5),对照组KPS评分升至70.0(70.0,77.5),两组比较差异有统计学意义(P<0.05)。结论补肾活血法在改善奥沙利铂周围神经毒性分级、提高生存质量方面均优于单纯西药治疗。

Objective To evaluate the clinical efficacy of Bushen Huoxue therapy against peripheral neurotoxicity induced by oxaliplatin.Methods A retrospective clinical case series of 48 patients with gastric cancer and colorectal cancer were included and reviewed in the study.These patients were divided into a TCM treatment group and a Western medicine control group,with 24 cases in each.The control group was treated with oxaliplatin plus capecitabine chemotherapy,and vitamin B6 was administered orally while the treatment group was supplemented with kidney-replenishing and blood-promoting Chinese medicine orally.The changes in peripheral neurotoxicity grades and KPS scores of the two groups were recorded and analyzed during four cycles of chemotherapy.Results Because of the low incidence of peripheral neurotoxicity in the first and second chemotherapy cycles,the difference in grades of peripheral neurotoxicity was not significant between the two groups.In the third cycle of chemotherapy,peripheral neurotoxicity was not detected in 9 cases,but 10 cases were found with Grade 1,and 5 cases with Grade 2 in the treatment group,compared to 4 cases,9 cases and 11 cases respectively in the control group.The grade of peripheral neurotoxicity in the treatment group was lower than that in the control group,and the difference was statistically significant(P<0.05).In the fourth cycle of chemotherapy,5 cases didn’t suffer from peripheral neurotoxicity,but 11 cases were found with Grade 1,7 cases with Grade 2,and 1 case with Grade 3 in the treatment group,compared to 3 cases,6 cases,9 cases and 6 cases in the control group.After four cycles of chemotherapy,the KPS score of the treatment group was significantly improved to 77.5(70.0,87.5),compared to 70(70.0,87.5)in the control group,and the difference was statistically significant.Conclusions The Chinese herbs for tonifying the kidney and promoting blood circulation can reduce peripheral neurotoxicity more effectively than Western medicine alone.