凉血通络方外洗防治甲磺酸阿帕替尼相关性手足综合征的临床效果

Clinical effect of Liangxuetongluo recipe external washing in preventing and treating apatinib mesylate-related handfoot syndrome

目的观察凉血通络方外洗防治甲磺酸阿帕替尼相关性手足综合征(HFS)的临床效果。方法选择2018年5月-2020年2月广州中医药大学顺德医院收治的使用甲磺酸阿帕替尼单药治疗的恶性肿瘤患者60例,采用随机数字表法分为观察组和对照组,每组30例。2组均采用甲磺酸阿帕替尼单药持续治疗。对照组给予常规方法预防HFS,观察组在对照组基础上联合凉血通络方外洗双手双足。比较2组患者HFS发生率及靶向药物甲磺酸阿帕替尼停药或减量情况。结果治疗后,观察组HFS发生率为26.7%,低于对照组的53.3%(χ^(2)=4.444,P=0.035);2组1、2级HFS发生率比较差异无统计学意义(P> 0.05),观察组3级HFS发生率低于对照组,差异有统计学意义(χ^(2)=4.043,P=0.044)。观察组未发生因HFS而导致甲磺酸阿帕替尼减量或停药情况,而对照组发生甲磺酸阿帕替尼减量或停药情况6例(20.0%),2组比较差异有统计学意义(χ^(2)=6.667,P=0.010)。结论凉血通络方外洗可有效防治甲磺酸阿帕替尼相关HFS,对保障靶向治疗顺利进行、提高患者的生活质量具有积极意义。

Objective To observe the clinical effect ofLiangxuetongluorecipe in the prevention and treatment of apatinib mesylate-related hand-foot syndrome(HFS).Methods 60 patients with malignant tumors treated with apatinib mesylate,who were admitted to the Shunde Hospital of Guangzhou University of Traditional Chinese Medicine from May 2018 to February 2020,were divided into observation group and control group using a random number table,each of 30 cases.Both groups were treated with apatinib mesylate as a single agent.The control group was given conventional methods to prevent HFS,and the observation group was combined withLiangxuetongluorecipe on the basis of the control group to wash hands and feet outside.The incidence of HFS and the discontinuation or reduction of the targeted drug apatinib mesylate were compared between the two groups.Results After treatment,the incidence of HFS in the observation group was 26.7%,which was lower than 53.3%in the control group(χ^(2)=4.444,P=0.035);There was no significant difference in the incidence of grade1 and 2 HFS between the two groups(P>0.05).The incidence of grade 3 HFS in the observation group was lower than that in the control group,and the difference was statistically significant(χ^(2)=4.043,P=0.044).There was no reduction or withdrawal of apatinib mesylate due to HFS in the observation group,while 6 cases of apatinib mesylate reduction or withdrawal in the control group(20.0%),the difference between the two groups was statistically significant(χ^(2)=6.667,P=0.010).Conclusion The external washing ofLiangxuetongluorecipe can effectively prevent and treat apatinib mesylate-related hand-foot syndrome,and has positive significance for ensuring the smooth progress of targeted therapy and improving the quality of life of patients.