耳穴压豆联合中药温通方外洗在减轻奥沙利铂化疗所致外周神经毒性疗效观察

Observation on the Efficacy of Ear Point Pressing Beans Combined with External Washing of Chinese Herbs in Alleviating Peripheral Neurotoxicity Induced by Oxaliplatin Chemotherapy

目的:探索耳穴压豆及中药外洗对奥沙利铂所致外周神经毒性的疗效。方法:选取2016年8月-2018年6月在我院肿瘤中心接受含奥沙利铂方案化疗的结直肠癌患者158例,其中愿意接受中医辅助治疗的患者132例随机分为3组,A组接受含奥沙利铂方案化疗联合耳穴压豆治疗,B组接受含奥沙利铂方案化疗联合中药温通方外洗治疗,C组接受含奥沙利铂方案化疗联合耳穴压豆及中药温通方外洗治疗,不愿意接受中医辅助治疗的患者26例归为D组,接受含奥沙利铂方案化疗。使用Levi神经毒性分级标准及KPS评分进行评分,对比治疗后外周神经毒性的发生率、程度差异及KPS评分变化情况。结果:耳穴压豆组、中药外洗组、耳穴压豆联合中药外洗组出现外周神经毒性的人数及3、4级外周神经毒性的比例均较单纯对症支持治疗组少,差异有统计学意义。所以,耳穴压豆、中药外洗、耳穴压豆联合中药外洗均能减少奥沙利铂外周神经毒性的发生率,改善患者症状,提高患者生活质量。

Objective:To explore the efficacy of ear acupoint pressing beans combined with external washing of traditional Chinese medicine on peripheral neurotoxicity induced by oxaliplatin. Methods:One hundred and fifty-eight patients with colorectal cancer received oxaliplatin-containing chemotherapy in our cancer center from August 2016 to June 2018 were selected. One hundred and thirty-two patients who were willing to receive TCM adjuvant therapy were randomly divided into three groups. Group A received chemotherapy with oxaliplatin plus ear acupoint pressing beans,group B received chemotherapy with oxaliplatin plus traditional Chinese medicine external washing,and group C received chemotherapy with oxaliplatin plus ear acupoint pressing beans and traditional Chinese medicine external washing. Twentysix patients who were unwilling to receive TCM adjuvant treatment were classified as group D. The Levi neurotoxicity grading standard and the KPS score were used to score,and the difference in the incidence or degree of peripheral neurotoxicity and the change in KPS score after treatment were compared. Result:Ear pressing beans group,traditional Chinese medicine external washing group,external ear pressing beans combined with traditional medicine external washing group showed the number of peripheral nerve toxicity and grade 3 or 4 peripheral neurotoxicity of proportion compared with less purely symptomatic and supportive treatment groups was statistically significant. So,ear point pressing beans and Chinese herbal medicine external washing and ear point pressing beans combined with Chinese herbal medicine external washing can reduce the incidence of oxaliplatin peripheral neurotoxicity,improve the symptoms of patients,and improve the quality of life of patients.