温经祛瘀蠲痹方联合甲钴胺对化学治疗药物导致的周围神经病变的疗效观察

Clinical effect of Wenjing-Quyu-Juanbi Prescription combined with methylcobalamin in treatment of chemotherapy-induced peripheral neuropathy

目的·观察温经祛瘀蠲痹方联合甲钴胺片口服治疗恶性肿瘤化学治疗(简称化疗)导致的周围神经病变(chemotherapyinduced peripheral neuropathy,CIPN)的临床效果。方法·采用随机数字表法将133例CIPN患者随机分为治疗组67例和对照组66例。对照组采用甲钴胺口服治疗,治疗组在甲钴胺口服治疗基础上,每日服用温经祛瘀蠲痹方水煎剂。治疗4周后分析2组患者中医临床症状积分及周围神经损伤分级的情况和治疗总有效率,比较2组的周围神经传导速度。结果·最终究成该研究患者123例,治疗组63例,对照组60例。2组治疗后手足麻木、时有疼痛、屈伸不利、神疲乏力、面色白或畏寒肢冷等症状积分均显著低于治疗前(均P<0.05),且治疗后治疗组各项症状积分均显著低于对照组(均P<0.05)。对周围神经损伤的治疗总有效率治疗组高于对照组(P<0.05)。2组治疗后正中神经和腓总神经的感觉神经传导速度及运动神经传导速度均显著快于治疗前(均P<0.05),且治疗后治疗组显著快于对照组(均P<0.05)。结论·温经祛瘀蠲痹方联合甲钴胺治疗CIPN的疗效优于单纯使用甲钴胺。

Objective · To observe the clinical effect of Wenjing-Quyu-Juanbi Prescription combined with methylcobalamin on chemotherapy-induced peripheral neuropathy (CIPN). Methods · A total of 133 CIPN patients were divided by random number table method into two groups, i.e. treatment group (n=67) and control group (n=66). Control group received oral methylcobalamin therapy, and treatment group received water decoction of Wenjing- Quyu-Juanbi Prescription on the basis of oral methylcobalamin therapy every day. After 4 weeks of treatment, the patients' symptom scores in traditional Chinese medicine and peripheral nerve injury grades in two groups were observed and total effective rates were calculated. The peripheral nerve conductive velocities between the two groups were compared. Results · The study was completed in 123 patients, 63 in the treatment group and 60 in the control group. After treatment, symptom scores of numbness of the extremities, pain, inconvenient flexion, mental fatigue, pale appearance and cold limbs were significantly lower than those before treatment (all P<0.05). And the symptom scores of treatment group after treatment were significantly lower than those of control group (all P<0.05). The total effective rate of treatment for peripheral nerve injury in treatment group was also higher than that in control group (P<0.05). Sensory nerve conduction velocity and motor nerve conduction velocity of median nerves and common peroneal nerves after treatment were all significantly faster than those before treatment (all P<0.05). And between the two groups they were faster in treatment group after treatment (P<0.05). Conclusion · The therapeutic effect of Wenjing-Quyu-Juanbi Prescription combined with methylcobalamin on CIPN is better than that of methylcobalamin only.