培元固本通痹方联合甲钴胺片治疗化疗所致周围神经病变气虚血瘀证临床研究

Clinical Study on Combination Use of Peiyuan Guben Tongbi Prescription and Meco⁃balamin Tablets for Chemotherapy-Induced Peripheral Neuropathy with Syndrome of Qi Deficiency and Blood Stasis

目的:观察培元固本通痹方联合甲钴胺片治疗化疗所致周围神经病变(CIPN)气虚血瘀证的疗效。方法:采用随机数字表法将98例CIPN气虚血瘀证患者分为治疗组、对照组各49例。对照组给予甲钴胺治疗,治疗组给予培元固本通痹方联合甲钴胺片治疗,2组连续治疗4周。比较2组临床疗效及治疗前后中医证候积分、周围神经毒性分级、下肢神经传导速度、下肢动脉血流速度。结果:治疗组总有效率89.80%,高于对照组73.47%(P<0.05)。治疗后,2组周围神经毒性分级、中医证候积分较治疗前降低(P<0.05),且治疗组周围神经毒性分级、中医证候积分低于对照组(P<0.05)。2组治疗后腓总神经和正中神经的感觉神经传导速度(SCV)、运动神经传导速度(MCV)及下肢腘动脉、股动脉血流速度均较治疗前加快(P<0.05),且治疗组腓总神经和正中神经的MCV、SCV及下肢腘动脉、股动脉血流速度快于对照组(P<0.05)。结论:培元固本通痹方联合甲钴胺片治疗CIPN气虚血瘀证疗效确切,能够减轻患者周围神经损伤,加快下肢神经传导速度及下肢动脉血流速度。

Objective:To observe the clinical effect of the combination use of Peiyuan Guben Tongbi Prescription and Mecobalamin Tablets on chemotherapy-induced peripheral neuropathy(CIPN)with syndrome of qi deficiency and blood stasis.Methods:A total of 98 CIPN patients with syndrome of qi deficiency and blood stasis were divided into the treatment group and the control group according to the random number table method,with 49 cases in each group.The control group was treated with Mecobalamin Tablets,and the treatment group was treated with Peiyuan Guben Tongbi Prescrition combined with Mecobalamin Tablets.The two groups were treated for four weeks.The clinical effects,and the traditional Chinese medicine(TCM)syndrome scores,peripheral neurotoxicity grading,and nerve conduction velocity and arterial blood flow velocity of lower limbs were compared before and after treatment between the two groups.Results:The total effective rate was 89.80%in the treatment group,higher than that of 73.47%in the control group(P<0.05).After treatment,the peripheral neurotoxicity grading and TCM syndrome scores in the two groups were reduced when compared with those before treatment(P<0.05),and the peripheral neurotoxicity grading and TCM syndrome scores in the treatment group were lower than those in the control group(P<0.05).After treatment,the sensory nerve conduction velocity(SCV)and motor nerve conduction velocity(MCV)of nervus peroneus communis and median nerve,and the blood flow velocity of popliteal artery and femoral artery of lower limbs in the two groups were faster than those before treatment(P<0.05),the MCV and SCV of nervus peroneus communis and median nerve,and the blood flow velocity of popliteal artery and femoral artery of lower limbs in the treatment group were faster than those in the control group(P<0.05).Conclusion:The combination use of Peiyuan Guben Tongbi Prescription and Mecobalamin Tablets has a definite curative effect on CIPN with syndrome of qi deficiency and blood stasis,which can reduce the peripheral nerve injury,and accelerate the nerve conduction velocity and arterial blood flow velocity of lower limbs.