加味黄芪桂枝五物汤治疗奥沙利铂慢性外周神经毒性的临床效果

Clinical effect of modified Huangqi Guizhi Wuwu Decoction in the treatment of peripheral neurotoxicity induced by Oxaliplatin

目的观察加味黄芪桂枝五物汤治疗奥沙利铂慢性外周神经毒性的临床效果。方法按照随机数字表法将2019年1月至2022年3月南京中医药大学附属盐城市中医院肿瘤科收治的46例奥沙利铂导致的慢性外周神经毒性的结直肠癌患者,将其分为对照组和观察组,各23例。对照组单纯化疗,治疗组在对照组的基础上配合加味黄芪桂枝五物汤颗粒,共治疗6个月。观察治疗前后两组化疗致外周神经毒性(CIPN20)评分、卡氏功能状态(KPS)评分、通用不良事件术语标准4.0版(血液毒性、消化道反应、肝肾功能)。结果治疗后,两组CIPN20评分较治疗前升高,KPS评分较治疗前降低(P<0.05),且治疗组CIPN20评分低于对照组,KPS评分高于对照组(P<0.05);观察组白细胞、血红蛋白、血小板分级优于对照组,但治疗后两组恶心、呕吐、腹泻、谷丙转氨酶升高、谷草转氨酶升高发生率比较,差异无统计学意义(P>0.05)。结论加味黄芪桂枝五物汤在临床应用可治疗奥沙利铂慢性外周神经毒性,提高患者生活质量,减轻化疗导致骨髓抑制,且安全可靠。

Objective To observe clinical effect of modified Huangqi Guizhi Wuwu Decoction in the treatment of peripheral neurotoxicity induced by oxaliplatin.Methods According to the random number table method,46 peripheral neurotoxicity induced by Oxaliplatin with colorectal cancer patients admitted to the Department of Oncology,Yancheng Traditional Chinese Medicine Hospital Affiliated to Nanjing University of Chinese Medicine from January 2019 to March 2022 were divided into control and treatment group,with 23 cases in each group.The control group was treated with chemotherapy alone,and the treatment group was treated with Huangqi Guizhi Wuwu Decoction Granules based on the control group,for a total of 6 months.Chemotherapy-induced peripheral neurotoxicity 20(CIPN)20 score,Karnofsky performance state(KPS)score,general adverse event terminology standard 4.0(blood toxicity,digestive tract reaction,liver,and kidney function)were observed in two groups before and after treatment.Results After treatment,CIPN20 score was higher than before treatment,and KPS score was lower than before treatment(P<0.05),and CIPN20 score in the treatment group was lower than the control group,and KPS score was higher than those in control group(P<0.05).The elassificatim of leukocyte,hemoglobin,and platele in the observation group was better than that in the control group,but there was no significant difference in the incidence of nausea,vomiting,diarrhea,elevated alanine aminotransferase,and oxalacetic aminotransferase between the two groups after treatment(P>0.05).Conclusion Modified Huangqi Guizhi Wuwu Decoction can effectively treat the peripheral neurotoxicity induced by oxaliplatin,improve the patient’s quality of life,and reduce myelosuppression,which is safe and reliable.