自拟通络活血汤熏洗配合低频脉冲防治奥沙利铂神经毒性临床观察

Clinical Observation of Fumigation-washing Therapy of Self-designed Tongluo Huoxue Decoction Combined with Low-frequency Pulse in the Prevention and Treatment of Oxaliplatin Neurotoxicity

目的:观察自拟通络活血汤熏洗配合低频脉冲对防治奥沙利铂神经毒性的临床疗效。方法:收集符合标准接受奥沙利铂联合化疗的患者82例,分为对照组和观察组,每组各41例,2组均接受6个疗程的基于奥沙利铂的方案化疗并同时全程口服B族维生素预防OPIN(奥沙利铂导致的末梢神经毒性),观察组在对照组的基础上在每个化疗周期的第1天至第5天予以自拟通络活血汤熏洗及足三里穴位低频脉冲电治疗。2组患者均在辅助化疗开始前及6个疗程的辅助化疗结束后分别对外周神经的传导速度进行检测,具体包括正中神经、腓肠神经及胫神经的感觉神经(SCV)传导速度和运动神经(MCV)传导速度。结果:对照组、观察组外周神经毒性发生率分别是65.85%、36.58%,差异有统计学意义(P<0.05);2组外周毒性出现的时间、毒性分级比较,差异均有有统计学意义(P<0.05);2组组患者经化疗后正中神经、腓总神经、胫神经的传导速度均可见不同程度的减慢,但观察组减慢的程度明显低于对照组(P<0.05)。结论:自拟通络活血汤配合低频脉冲可有效防治奥沙利铂所引起的外周神经毒性。

Objective:To observe the clinical efficacy of self-made Tongluo Huoxue decoction combined with low-frequency pulse in the prevention and treatment of oxaliplatin neurotoxicity.Methods:A total of 82 patients who met the criteria for receiving oxaliplatin combined chemotherapy were divided into control group and observation group,each with 41 cases.Both groups received 6 courses of oxaliplatin-based chemotherapy and the whole course at the same time Oral B vitamins to prevent OPIN (peripheral neurotoxicity caused by oxaliplatin),the observation group received self-made Tongluo Huoxue decoction and Zusanli on the basis of the control group from day 1 to day 5 of each chemotherapy cycle Acupoint low-frequency pulse electric therapy.The conduction velocities of the peripheral nerves were measured before the start of adjuvant chemotherapy and after the end of 6 courses of adjuvant chemotherapy,including the conduction velocity of the median nerve,sural nerve,and sensory nerve (SCV) of the tibial nerve and motor nerve.(MCV) Conduction velocity.Results:The incidence of peripheral neurotoxicity in the control group and the observation group were 65.85% and 36.58%,respectively,and the difference was statistically significant (P<0.05);the comparison of the time of appearance of peripheral toxicity and toxicity classification in the two groups was statistically significant (P<0.05);After chemotherapy,the conduction velocity of the median nerve,common peroneal nerve,and tibial nerve of the two groups of patients was slowed down to varying degrees,but the slowdown of the observation group was significantly lower than that of the control group (P<0.05).Conclusion:Self-made Tongluo Huoxue decoction combined with low-frequency pulse can effectively prevent and treat the peripheral neurotoxicity caused by oxaliplatin.