加减桂枝汤防治卡培他滨相关性手足综合征的临床研究

Clinical study on the prevention and treatment of capecitabine-related hand-foot syndrome by modified Guizhi Decoction

目的比较加减桂枝汤与维生素B6软膏外用在防治卡培他滨相关手足综合征(HFS)的临床疗效。方法选取在该院住院接受含卡培他滨方案化疗的恶性肿瘤患者80例,分为观察组与对照组,各40例。观察组在化疗开始时同期外用加减桂枝汤药液浸泡双手足,每次浸泡20min,每天早晚各1次;对照组在化疗开始时同期外用维生素B6软膏适量外涂双手足皮肤,每天早晚各1次。21d为1个周期,两组均观察2个周期。比较两组患者HFS发生情况、血清环氧合酶-2(COX-2)水平、皮肤病生活质量指标(DLQI)评分及不良反应发生情况。结果化疗结束时,对照组HFS发生率(42.5%)高于观察组(15.0%),差异有统计学意义(P<0.05);化疗第21、42天,对照组血清COX-2水平均高于观察组,差异有统计学意义(P<0.01)。两组DLQI评分稳定及增加患者比例比较,差异无统计学意义(P>0.05)。结论中药加减桂枝汤可降低患者外周血COX-2水平,延缓HFS的发生,降低HFS发生的程度。

Objective To compare the clinical efficacy of external application of modified Guizhi Decoction and vitamin B 6 ointment in the prevention and treatment of capecitabine-related hand-foot syndrome(HFS).Methods A total of 80 patients with malignant tumors who received chemotherapy with capecitabine in this hospital were selected and divided into the observation group and the control group,with 40 cases in each group.For patients in the observation group,at the beginning of the chemotherapy,external use of modified Guizhi Decoction solution was applied to soak hands and feet,20 min each time,twice a day in the morning and evening.For patients in the control group,at the beginning of the chemotherapy,external application of vitamin B 6 ointment was applied to the skin of both hands and feet,twice a day in the morning and evening.Twenty-one days was a cycle,and both groups observed 2 cycles.The incidence of HFS,serum cyclooxygenase-2(COX-2)level,skin disease quality of life index(DLQI)score and incidence of complications were compared between the two groups.Results At the end of chemotherapy,the incidence rate of HFS in the control group(42.5%)was higher than that in the observation group(15.0%),and the difference was statistically significant(P<0.05).At the 21st and 42nd day of chemotherapy,the serum levels of COX-2 in the control group were higher than those in the observation group,and the differences were statistically significant(P<0.01).There was no significant difference in the proportion of patients with stable or increased DLQI score between the two groups(P>0.05).Conclusion Chinese herbal medicine modified Guizhi Decoction can reduce the level of COX-2 in peripheral blood of patients,delay the occurrence of HFS,and reduce the incidence of HFS.