外洗通络方治疗化疗引起的周围神经病变34例临床观察

Clinical Observation of Network Vessel-Freeing Formula as a Topical Wash Combined for 34 Cases of Chemotherapy-Induced Peripheral Neuropathy

目的观察外洗通络方治疗化疗药物引起的周围神经病变的临床疗效。方法将68例化疗引起的周围神经病变患者随机分为外洗方组和西药组各34例。外洗方组以外洗通络方外洗,每次60min,每日1次;西药组采用腺苷钴胺肌肉注射,每次1mg,每日1次,两组均治疗14天后观察疗效。比较两组临床疗效及外洗方组不同化疗药物引起的周围神经病变疗效、不同病情分级疗效,同时观察各组不良反应。结果外洗方组临床疗效总有效率为61.76%,西药组为38.24%,两组比较差异无统计学意义(P>0.05)。外洗方组因奥沙利铂引起的周围神经病变21例,总有效率为80.95%;因紫杉醇引起的周围神经病变13例,总有效率30.77%,两种化疗药物引起的周围神经病变疗效比较差异无统计学意义(P>0.05)。外洗方组周围神经病变1级者7例,有效率为71.43%;2级19例,有效率为63.16%;3级8例,有效率为50.00%,各级病情疗效比较差异无统计学意义(P>0.05)。治疗期间各组均未出现与治疗相关的不良反应。结论外洗通络方治疗化疗引起的周围神经病变与腺苷钴胺肌肉注射疗效相当并且对奥沙利铂引起的周围神经病变有更好的疗效趋势。

Objective To observe the therapeutic effect and its influencing factors of network vessel-freeing formula as a topical wash for chemotherapy-induced peripheral neuropathy （C IPN） .Methods Sixty eight cases of CIPN were randomized into the treatment group and control group , with 34cases in each.The treatment group was given network vessel-freeing formula as a topical wash , 60min each time once daily.The control group was treated with intramuscular injection of cobamamide , 1mg each time , once daily.The grading scores of peripheral neurotoxicity were observed and compared in both groups before and after 14-day treatment according to CIPN questionnaire.Results There were 7cases excellent , 14cases valid and 13cases invalid in the treatment group , with a total effective rate of 61.76%.There were 4cases excellent , 9cases valid and 21cases invalid in the control group , with a total effective rate of 38.24%.There was no significant difference between groups in the total effective rate （ P〈0.05 ） .There were 5cases excellent , 12cases valid and 4cases invalid among 21cases of CIPN induced by oxaliplatin in the treatment group , with a total effective rate of 80.95%.There were 2cases excellent , 4cases valid and 7cases invalid among 13cases of CIPN induced by paclitaxel in the treatment group , with a total effective rate of 30.77%.There was no significant difference between different chemotherapy drugs in the treatment group （ P〈0.05 ） .There were 5cases valid and 2cases invalid among 7cases of peripheral neuropathy （ grade 1 ）, with a total effective rate of 71.34%in the treatment group. There were 12cases valid and 7cases invalid among 19cases of peripheral neuropathy （ grade 2 ）, with a total effective rate of 63.16%in the treatment group.There were 4cases valid and 4cases invalid among 8cases of peripheral neuropathy （ grade 3） , with a total effective rate of 50.00%in the treatment group.The pairwise comparisons showed no significant difference （ P〈0.05 ） .There was no treatment-related adverse reaction.Conclusion The therapeutic effect of network vessel-freeing formula for CIPN is as same as that of cobamamide , with a better effect on CIPN induced by oxaliplatin.