除痹方治疗胃肠恶性肿瘤使用奥沙利铂联合卡培他滨引起的手足综合征的临床观察

Clinical Observation of Chubi Formula in the Treatment of Hand-Foot Syndrome Caused by Oxaliplatin Combined with Capecitabine in Gastrointestinal Carcinoma

目的评价除痹方泡敷手足治疗胃肠恶性肿瘤使用奥沙利铂联合卡培他滨化疗引起的手足综合征(hand-foot syndrome,HFS)的临床疗效。方法选取在东莞市中医院门诊或住院的HFS患者60例,按照随机原则分为试验组30例和对照组30例,两组均给予尿素软膏保持皮肤湿润,防止手足皲裂,疼痛明显者可服用塞来昔布0.2 g两次/日缓解疼痛。试验组在基础处理上加用除痹方泡敷,每天两次,每次泡敷30分钟,观察时间为3周。3周后对两组HFS有效率、HFS相关临床症状、HFS患者生活质量、减药及停药人数、不良反应进行对比,全面评价除痹方泡敷对HFS的的临床疗效。结果治疗后试验组HFS有效率高于对照组(P<0.05),HFS相关临床症状积分低于对照组(P<0.05),且治疗后试验组HFS生活质量高于对照组(P<0.05)。试验组因HFS减药及停药人次少于对照组,两组的差异无统计学意义(P>0.05),两组均未观察到特殊的不良反应,除痹方的安全性良好。结论除痹方泡敷手足对胃肠恶性肿瘤使用奥沙利铂联合卡培他滨化疗引起的手足综合征有较好的疗效,且安全性好,值得临床推广。

Objective To evaluate the clinical efficacy of Chubi Formula in the treatment of hand-foot syndrome(HFS)caused by Oxaliplatin combined with Capecitabine in gastrointestinal carcinoma.Methods 60 patients with HFS who received outpatient or inpatient treatment in Dongguan Hospital of Traditional Chinese Medicine were divided into an experimental group and a control group according to the randomized principle,with 30 cases in each group.Both groups were given urea ointment to keep skin moist and prevent cracked hand and foot.Patients with obvious pain could take Celecoxib 0.2 g twice a day to relieve pain.The experimental group was additionally treated with Chubi Formula by soaking and applying for 30 minutes,twice a day,with an observation period of 3 weeks.After 3 weeks,the effective rates of HFS,clinical symptoms related to HFS,quality of life of HFS patients,cases of drug reduction and discontinuation,and adverse reactions were compared between the two groups to evaluate the clinical efficacy of Chubi Formula on HFS.Results The effective rate of HFS in the experimental group was higher than that in the control group(P<0.05),and the clinical symptom score related to HFS was lower than that in the control group(P<0.05).In addition,the quality of life of HFS in the experimental group was higher than that in the control group(P<0.05).The cases of drug reduction and discontinuation due to HFS in the experimental group was fewer than that in the control group,and the difference between the two groups was not statistically significant(P>0.05).No special adverse reactions were observed in both groups,indicating good safety of Chubi Formula.Conclusion Soaking and applying hand and foot with Chubi Formula has a good therapeutic effect on HFS caused by Oxaliplatin combined with Capecitabine in gastrointestinal carcinoma,and it is safe as well as worthy of clinical promotion.