甲钴胺联合谷胱甘肽对肺癌化疗患者神经毒性反应的防治价值

Preventive and therapeutic value of mecobalamin combined with glutathioneon against neurotoxicity in patients receiving chemotherapy for lung cancer

目的探讨甲钴胺分散片联合还原型谷胱甘肽对肺癌化疗患者神经毒性反应的防治效果。方法选取2015年1月至2016年6月间广东省江门市中心医院收治的84例肺癌化疗患者,采用随机数表法分为观察组和对照组,每组42例。观察组患者行甲钴胺分散片联合还原型谷胱甘肽注射液治疗,对照组患者行还原型谷胱甘肽注射液治疗。采用Levi专用感觉神经毒性分级,分别观察两组肺癌化疗患者接受化疗4、6个周期时神经毒性反应的发生率。患者治疗6个周期时,分析甲钴胺联合谷胱甘肽对降低肺癌化疗患者神经毒性反应的总有效率。结果观察组患者急性神经毒性反应发生率高于对照组患者,均为诱发的肢端麻木,两组比较,差异无统计学意义(P>0.05)。接受化疗4、6个周期后,观察组患者0级神经毒性反应发生率(61.9%)明显高于对照组(33.3%),观察组患者1~3级神经毒性反应发生率明显低于对照组,差异均有统计学意义(均P<0.05)。观察组患者接受化疗6周期时,降低神经毒性反应总有效率为90.5%,明显高于对照组的78.6%,差异有统计学意义(P<0.05)。结论甲钴胺联合还原型谷胱甘肽可有效降低肺癌化疗患者慢性神经毒性反应发生率,提高临床治疗有效率,对肺癌化疗患者发生神经毒性反应具有较高的防治价值,值得临床推广。

Objective To analyze the preventive and therapeutic efficacy of mecobalamin combined with glutathione against neurotoxicity in patients with lung cancer receiving chemotherapy. Methods Eighty-four patients receiving chemotherapy for lung cancer at Jiangmen Central Hospital from January 2015 to June 2016 were selected. Patients were divided into an observation group and a control group according to the random number table method. Patients in the observation group were treated with mecobalamin combined with glutathione injection. Patients in the control group were treated with glutathione injection. Levi specific sensory neurotoxicity classification was uesed to observe the incidence of neurotoxicity at 4 and 6 cycles of chemotherapy,respectively. The overall efficacy rate of mecobalamin combined with glutathione in reducing the neurotoxicity was analyzed when the patients were treated for 8 cycles. Results The incidence of acute neurotoxicity in the observation group was higher than in the control group and for both groups it was induced by limb numbness（P〉0. 05）. At 4 and 6 cycles of chemotherapy,grade 0 neurotoxicity reaction rate（61. 9%） was significantly higher in the observation group than in the control group（33. 3%） and Pgrade1 ～ 3 neurotoxicity was significantly lower in the observation group than in the control group（P〈0. 05）. At8 cycles of chemotherapy,the overall efficiency rate in reducing neurotoxicity was 90. 5% for the observation group which was higher than 78. 6% of the control group（P〈0. 05）. Conclusion Mecobalamin combined with glutathione can effectively reduce the incidence of chronic neurotoxicity and improve clinical efficiency,which has high significance in the prevention of neurotoxicity in patients with lung cancer and is worthy of clinical promotion.