针刺联合普瑞巴林治疗CIPN疗效观察

Clinical Observation of Acupuncture Combined with Pregabalin in the Treatment of CIPN

目的:观察针灸联合普瑞巴林治疗肿瘤患者化疗相关性周围神经病变(CIPN)的临床疗效。方法:选取符合CIPN诊断标准的病例,根据患者意愿,分为试验组25例和对照组23例,对照组口服普瑞巴林胶囊,每次75mg,2次/d,2周为1疗程,试验组在此基础上加以普通针刺太渊、血海、足三里、合谷(左右各一,共8个)穴位,每2周中第1周针刺4次,停针1周,两周为1疗程。两组患者均治疗2个疗程。观察两组患者NCI-CTCAEV5.0CIPN分级情况、EORTCQLQ-CIPN20量表评分和疼痛数字评分量表(NRS)评分。结果:①CIPN分级疗效方面,试验组总有效率(80.00%)明显高于对照组(39.13%)(P<0.05);②CIPN20量表评分与NRS量表评分方面,组间比较,治疗后试验组患者相关评分均低于对照组(P<0.05);组内比较,试验组患者在治疗后相关评分低于治疗前评分(P<0.05),对照组治疗后相关评分稍低于治疗前,但结果比较,差异无统计学意义(P>0.05)。结论:相对于单纯口服普瑞巴林,针灸联合普瑞巴林在治疗CIPN方面可显著降低患者周围神经症状分级,促进患者CIPN20量表评分及NRS量表评分下降,改善患者临床症状,疗效确切。

Objective:To observe the clinical efficacy of acupuncture combined with pregabalin capsules in the treatment of chemotherapy-induced Peripheral Neuropathy(CIPN)in cancer patients.Methods:The inpatients who met the CIPN diagnostic criteria were enrolled.According to the patients'will,the patients were divided into the treatment group(n=25)and the control group(n=23).The control group received oral pregabalin capsules,75 mg twice a day,for a treatment course of two weeks.In addition to this,the treatment group was treated with ordinary acupuncture at Taiyuan,Xuehai,Zusanli,and Hegu(8 acupoints on each side).Acupuncture was administered four times in the first week of a two-week treatment course,with a one-week break between treatment courses.The NCI-CTCAE V5.0 CIPN grade,EORTC QLQ-CIPN20 scale score,and pain Number scale(NRS)score of the two groups were observed.Results:(1)In terms of CIPN classification,the total effective rate of the treatment group(80%)was significantly higher than that of the control group(39.13%)(P<0.05).In terms of the CIPN20 score and NRS score,the scores of the treatment group were lower than those of the control group after treatment(P<0.05).(2)In the intra-group comparison,the correlation score after treatment in the treatment group was significantly lower than that before treatment(P<0.05),while the correlation score after treatment in the control group was slightly lower than that before treatment,but there was no statistical difference(P>0.05).Conclusion:Compared with oral pregabalin capsule alone,the combination of acupuncture and pregabalin in the treatment of CIPN can significantly reduce the severity of peripheral nerve symptoms,promote a reduction in CIPN20 scale score and NRS scale score,and improve the clinical symptoms of patients.