甘麦大枣汤联合十宣气端放血治疗对血液肿瘤患者化疗所致末梢神经炎的临床研究

Clinical study of Ganmai Dazao Decoction combined with Shixuan qi-end bloodletting therapy on peripheral neuritis caused by chemotherapy in patients with hematological malignancies

关键词:  血液肿瘤  末梢神经炎  甘麦大枣汤  十宣气端放血  炎性因子  免疫功能

Key words:  blood tumor  peripheral neuritis  Ganmai Dazao Decoction  Shixuan qi-end bloodletting  inflammatory factors  immune function

摘要:

[目的] 探究甘麦大枣汤联合十宣气端放血治疗对血液肿瘤患者化疗所致末梢神经炎的临床研究。[方法] 选取60例患者，随机分为对照组30例、治疗组30例，其中阳性对照患者19例，阴性对照患者11例。给予十宣气端放血治疗以及使用西药甲钴胺进行治疗；研究组给予甘麦大枣汤联合十宣气端放血治疗。评定中医证候积分水平变化；采用数字评价量表法（NRS）评估患者疼痛程度；采用流式细胞仪检测患者T淋巴细胞亚群（CD4⁺、CD8⁺、CD4⁺/CD8⁺）水平；采用专用感觉神经毒性标准评定患者化疗后神经毒性反应情况；酶联免疫吸附试验法检测白细胞介素-1β（IL-1β）、肿瘤坏死因子-α（TNF-α）水平，对比两组治疗效果。[结果] 治疗后，与对照组相比，治疗组下肢麻木、倦怠乏力、四肢疼痛评分、NRS评分、CD8⁺水平、神经毒性反应2级、3级、4级情况、TNF-α、IL-1β水平均降低（P<0.05）；CD4⁺、CD4⁺/CD8⁺水平、神经毒性反应0级、1级情况均升高（P<0.05）。治疗组总有效率高于对照组（P<0.05）。[结论] 通过采用甘麦大枣汤联合十宣气端放血对血液肿瘤患者化疗所致末梢神经炎患者进行治疗，能够显著降低中医证候积分水平，减轻患者自身疼痛程度，改善机体免疫功能及神经毒性反应，从而对机体炎症反应情况的严重程度进行显著减轻，改善临床症状，治疗效果显著。

Abstract:

[Objective] To explore the clinical study of Ganmai Dazao Decoction combined with Shixuan qi-end bloodletting on peripheral neuritis caused by chemotherapy in patients with hematological tumors. [Methods] A total of 60 patients were selected and randomly divided into a control group of 30 and a treatment group of 30, including 19 positive controls and 11 negative controls. The patients were given Shixuan qi-end bloodletting treatment and western medicine methylcobalamin for treatment;the research group was given Ganmai Dazao Decoction combined with Shixuan qi-end bloodletting treatment. Evaluate the changes of traditional Chinese medicine(TCM) syndrome scores;use Numerical Rating Scale(NRS) to evaluate the pain degree of patients;use flow cytometry to detect the levels of CD4⁺, CD8⁺, CD4⁺/CD8⁺ in patients;use special sensory neurotoxicity criteria to evaluate patients' neurotoxicity after chemotherapy;enzyme-linked immunosorbent assay was used to detect the levels of interleukin-1β(IL-1β) and tumor necrosis factor-α(TNF-α), and the two groups were compared. treatment effect. [Results] After treatment, compared with the control group, lower limb numbness, fatigue, limb pain score, NRS score, CD8⁺ level, neurotoxicity grade 2, 3, 4, TNF-α and IL-1β levels in the treatment group were decreased(P<0.05). The levels of CD4⁺, CD4⁺/CD8⁺, grade 0 and grade 1 neurotoxicity were increased(P<0.05). The total effective rate in treatment group was higher than that in control group(P<0.05). [Conclusion] The use of Ganmai Dazao Decoction combined with Shixuan qi-end bloodletting to treat patients with peripheral neuritis caused by chemotherapy in patients with hematological tumors can significantly reduce the level of TCM syndrome scores, reduce the patient's own pain, and improve the body's immune function and neurotoxicity. Thereby, the inflammatory response of the body is significantly reduced, the clinical symptoms are improved, and the treatment effect is remarkable.