基于“扶正祛毒化瘀”法治疗多发性骨髓瘤周围神经病变经验

Treatment of Multiple Myeloma-Induced Peripheral Neuropathy Based on Method of"Strengthening Body Resistance,Detoxifying,and Dispersing Blood Stasis"

多发性骨髓瘤(MM)是以贫血、骨痛和溶骨性破坏等为主要临床表现的中老年浆细胞克隆性增殖性肿瘤。40%~60%经药物化疗过后的MM患者会出现不同程度的多发性骨髓瘤周围神经病变(MMPN),而作为化疗药物之一的蛋白酶体抑制剂,是MM患者经化疗后出现MMPN的诱因之一。由于其副作用较大,严重影响了患者的依从性,导致临床效果大打折扣。同时,虽然其在一定程度上缓解了病情,但是患者的生活质量仍严重下降。所以,提高疗效与患者的生存质量非常必要。李秀军教授基于“正气亏虚,瘀毒痹阻经络”理论,以“扶正祛毒化瘀”为主要治则,予患者自拟扶正祛毒化瘀方内服,并配合普通针刺以补脾益肾、通经活络,治疗效果颇佳。

Multiple myeloma(MM)is a clonal proliferative tumor of plasma cells that occurs mainly in middle-aged and elderly people,and its main clinical manifestations are anemia,bone pain,and osteolytic destruction.40%–60%of MM patients after drug chemotherapy will have diferent degrees of MM-induced peripheral neuropathy(MMPN).Proteasome inhibitors,as one of the chemotherapeutic drugs,are one of the causes of MMPN in MM patients after chemotherapy.Due to itslarge side efects,the compliance of patients is seriously afected,resulting in a signifcant reduction in clinical efects.Although the disease is alleviated to a certain extent,the quality of life of patients is still seriously decreased.Therefore,it is very necessary to improve the curative efect and quality of life of the patients.Based on the theory of"a defciency of body health and obstruction of meridians by blood stasis and poison",Professor Li Xiujun took"strengthening body resistance,detoxifying,and dispersing blood stasis"as the main treatment principle and used Fuzheng Qudu Huayu Formula combined with ordinary acupuncture to tonify the liver and kidney and activate meridians.The therapeutic efect was great.