三两三加减方防治奥沙利铂神经毒性的临床研究

Clinical research of modified Sanliangsan for neurotoxicitydue to oxaliplatin

目的观察三两三加减方防治奥沙利铂神经毒性的临床疗效。方法将106例胃癌和结直肠癌患者按照随机数字表法分为2组。对照组53例采用含有奥沙利铂的mFOLFOX6化疗方案治疗,治疗组53例在对照组治疗基础上予三两三加减方治疗27周。比较2组急慢性神经毒性发生情况,治疗后中医证候评分,并统计2组疗效。结果治疗组总有效率94.34%(50/53),对照组总有效率71.70%(38/53),治疗组实体瘤疗效优于对照组(P<0.05)。化疗3个周期治疗组神经毒性发生率49.06%(26/53),低于对照组[77.36%(41/53),(P<0.05)];化疗6个周期后治疗组神经毒性发生率75.47%(40/53),低于对照组[92.45%(49/53),(P<0.05)]。治疗后治疗组中医证候各项评分均低于对照组(P<0.05)。结论三两三加减方可有效降低含奥沙利铂化疗方案所致神经毒性发生率,有效缓解临床症状,提高疗效,值得临床推广。

Objective To observe the clinical efficacy of modified Sanliangsan for neurotoxicity due to oxaliplatin.Methods Totally 106 patients with gastric cancer or colorectal cancer were randomly divided into two groups,53 cases in control group were treated with mFOLFOX6 regimen(oxaliplatin,leucovorin,and fluorouracil),and 53 cases in treatment group were additionally treated with modified Sanliangsan on the basis of control group for 27 weeks.The key observation was the occurrence of neurotoxicity,traditional Chinese medicine(TCM)syndrome score,and curative effect between groups after treatment.Results The total effective rates in treatment group were better than those in control group[94.34%(50/53)vs 71.70%(38/53),(P<0.05),respectively].The incidence rate of neurotoxicity for 3-cycle and 6-cycle in treatment group was lower than that in control group[49.06%(26/53)vs 77.36%(41/53),(P<0.05);75.47%(40/53)vs 92.45%(49/53),(P<0.05);respectively];TCM syndrome score in treatment group was lower than that in control group(P<0.05).Conclusion For neurotoxicity due to oxaliplatin,modified Sanliangsan can effectively reduce the incidence rate,alleviate the clinical symptoms,improve the curative effect,and it is worthy of clinical promotion.