“益气活血汤”药物透入治疗气虚血瘀型奥沙利铂所致外周神经毒性病变的临床研究

Clinical study on the treatment of peripheral neurotoxic lesions caused by oxaliplatin with qi-deficiency and blood-stasis by the drug penetration of “Yiqi Huoxue Decoction”

关键词:  外周神经毒性  化疗  奥沙利铂  中药透药疗法  临床疗效

Key words:  peripheral neurotoxicity  chemotherapy  oxaliplatin  traditional Chinese medicine penetration therapy  clinical efficacy

摘要:

[目的] 观察以益气活血汤为基础，通过超声电导仪药物透入疗法对因奥沙利铂导致的外周神经毒性的临床疗效。[方法] 将60例符合筛选标准的患者随机分为治疗组与对照组。治疗组30例，予益气活血汤透药联合甲钴胺片；对照组30例，单纯服用甲钴胺片。观察两组治疗前后神经毒性分级、中医证候评分、免疫功能指标（T淋巴细胞亚群水平）的变化。[结果] 与对照组比较，治疗组临床症状改善率明显提高（P<0.01）。与对照组比较，治疗组可有效降低外周神经毒性Ⅰ~Ⅱ级发生率，差异有统计学意义（P<0.05）。免疫功能（总T淋巴细胞）比较，治疗组明显高于对照组（P<0.05）。[结论] 自拟益气活血汤通过超声电导仪药物透入疗法方式给药后能够有效的降低神经毒性分级，提高患者免疫力，改善气虚血瘀证患者的中医证候相关症状，且无明显不良反应，对肿瘤治疗起到增效减毒的作用，值得临床推广。

Abstract:

[Objective] To observe the clinical effect of Yiqi Huoxue Decoction on peripheral neurotoxicity caused by oxaliplatin through ultrasound conductivity meter drug penetration therapy.[Methods] The 60 patients who met the screening criteria were randomly divided into a treatment group and a control group. Thirty patients in the treatment group were treated with Yiqi Huoxue Decoction combined with Mecobalamin tablets. The 30 patients in the control group were treated with mecobalamin tablets alone. The changes of neurotoxicity grade,traditional Chinese medicine syndrome score and immune function index (T lymphocyte subsets level) were observed before and after treatment in the two groups.[Results] Compared with the control group,the improvement rate of clinical symptoms in the treatment group was significantly improved (P<0.01). Compared with the control group,the treatment group can effectively reduce the incidence of peripheral neurotoxicity Ⅰ to Ⅱ,the difference is statistically significant (P<0.05),and the immune function (total T lymphocyte) in the treatment group was significantly higher than that in the control group (P<0.05).[Conclusion] Self-made Yiqi Huoxue Decoction can effectively reduce the neurotoxicity grading,improve the immunity of patients,improve the symptoms related to traditional Chinese medicine syndromes of patients with qi-deficiency and blood-stasis syndrome,and has no obvious adverse reactions,which played a synergistic and detoxifying role in the treatment of tumors. It is worth popularizing in clinical practice.