化疗相关周围神经病变诊治的研究进展

Progress on Diagnosis and Treatment of Chemotherapy-Induced Peripheral Neuropathy

化疗相关周围神经病变(chemotherapy-induced peripheral neuropathy,CIPN)是肿瘤患者中常见的一种治疗相关毒副作用,多种化疗药物与之相关。患者通常出现手脚麻木、疼痛的症状,严重降低生活质量。由于CIPN发病机制不明,缺乏诊断评估手段和预防治疗策略,困扰了众多临床医师和患者。近年来相关研究表明,临床上可以识别CIPN高危患者以进行预防,诊断和评估需要联合患者的病史、症状体征以及神经电生理进行综合考量,除降低化疗药物剂量和(或)延长用药间隔外,度洛西丁可以缓解疼痛症状;一些物理治疗策略,如冷冻治疗、加压治疗、针灸等取得了一些有意义的结果;中医也凸显了一定优势,为临床治疗决策提供了更多选择。

Chemotherapy-induced peripheral neuropathy(CIPN)is a common treatment-related adverse effect in cancer survivors,and is associated with multiple chemotherapy drugs.Patients often experience numbness and pain in both hands and feet,which severely affect their quality of life.Due to the unknown pathogenesis and the lack of evaluation methods,preventive and treatment strategies,CIPN has become a challenge for both clinicians and patients.In recent years,relevant studies have shown that high-risk patients can be identified for prevention,the comprehensive consideration of medical history,symptoms and signs,neuroelectrophysiology can help diagnostic evaluation of CIPN.In addition to reducing the dose of chemotherapy drugs and/or prolonging the interval between medications,duloxetine can relieve pain symptoms,and physical therapy such as cryotherapy,compression therapy,acupuncture,etc.are beneficial for CIPN patients.Besides,traditional Chinese medicine has also highlighted certain advantages.All of the above provide more choices for clinical treatment decisions.