解氏祛浊解毒汤治疗紫杉醇化疗后外周神经毒性的研究

Study of Xieshi Quzhuo Jiedu Decoction on paclitaxel-induced peripheral neurotoxicity

目的探讨解氏祛浊解毒汤对紫杉醇化疗所导致的外周神经毒性的治疗作用。方法将2019年7月至2021年2月在大连市妇女儿童医疗中心(集团)春柳妇产院区妇科肿瘤科接受紫杉醇化疗并出现神经毒性症状的60例患者纳入研究。患者随机分为观察组(解氏祛浊解毒汤口服+熏洗治疗)和对照组(甲钴胺口服治疗),对两组患者治疗前后的神经毒性评估、生活质量评分及外周神经传导速度进行分析。结果观察组和对照组基线状况相当,具有可比性(P>0.05)。观察组总有效率高于对照组(76.7%vs.36.7%,P=0.002)。治疗后观察组总体健康状况评分高于对照组[(80.6±11.2)分vs.(71.4±14.3)分,P=0.019],观察组躯体功能评分高于对照组[(90.4±9.0)分vs.(81.3±14.9)分,P=0.017]。观察组疼痛评分为(10.0±10.4)分,对照组疼痛评分为(17.8±15.1)分,观察组疼痛症状较对照组减轻(P=0.04)。通过神经肌电图检测两组神经传导速度,治疗前观察组和对照组腓总神经感觉神经传导速度(Sensory nerve conduction velocity,SNCV)分别为(52.1±4.8)m/s和(52.2±4.3)m/s,两组差异无统计学意义(P=0.892)。治疗后观察组SNCV为(55.6±3.2)m/s,对照组为(53.6±3.8)m/s,观察组较对照组有所提高(P=0.03)。治疗前后,观察组与对照组的腓总神经运动神经传导速度(Motor nerve conduction velocity,MNCV)差异均无统计学意义(P>0.05)。结论采用解氏祛浊解毒汤治疗紫杉醇化疗导致的外周神经毒性具有良好的疗效。

Objective To investigate the therapeutic effect of Xieshi Quzhuo Jiedu Decoction on paclitaxel-induced peripheral neurotoxicity.Methods Sixty patients who received paclitaxel chemotherapy and developed neurotoxic symptoms in the Department of Gynecology Oncology,Dalian Women and Children′s Medical Center(Group)Chunliu Obstetrics and Gynecology Hospital Distric from July 2019 to February 2021 were included in this study.Patients were randomly divided into observation group(treated with Xieshi Quzhuo Jiedu Decoction and fumigation soup)and control group(treated with oral mesocobalamin).The neurotoxicity assessment,quality of life scores,and peripheral nerve conduction speed before and after treatment in the two groups were analyzed.Results The baseline condition was comparable between the two groups(P>0.05).The total effective rate in the observation group was higher than that in control group(76.7%vs.36.7%,P=0.002).After treatment,the overall health status score of the observation group was 80.6±11.2,and the control group was 71.4±14.3.The overall health status score of the observation group was higher than the control group(P=0.019).The somatic function score of the observation group was 90.4±9.0,the control group was 81.3±14.9,and the observation group was higher than the control group(P=0.017).The pain score of the observation group was 10.0±10.4,while the control group was 17.8±15.1,and the pain score of the observation group were lower compared with the control group(P=0.04).The nerve conduction velocity of the two groups was detected by nerve electromyography.The common peroneal nerve sensory nerve conduction velocity(SNCV)in the observation group and control group was(52.1±4.8)m/s and(52.2±4.3)m/s,respectively;there was no statistical difference between the two groups(P=0.892).After treatment,the SNCV was(55.6±3.2)m/s in the observation group,and(53.6±3.8)m/s in the control group.The SNCV of observation group was improved compared with control group(P=0.03).There was no statistical difference in motor nerve conduction velocity(MNCV)of common peroneal nerve between the observation group and the control group before or after treatment(P>0.05).Conclusion Xieshi Quzhuo Jiedu Decoction has good efficacy in the treatment paclitaxel-induced peripheral neurotoxicity.