摘要
Objective:To observe the preventive and treatment effects of warming needle therapy on peripheral neuropathy after albumin-bound paclitaxel plus cisplatin chemotherapy.Methods:Eighty patients who received albumin-bound paclitaxel plus cisplatin chemotherapy after being diagnosed with cancer were divided into an observation group and a control group using the simple random allocation table method,with 40 cases in each group.The control group received methylcobalamin dispersible tablets via oral administration,and the observation group received warming needle therapy.They were observed for the incidence of chemotherapy-induced peripheral neuropathy(CIPN),Levi’s specific sensory neurotoxicity grading,brief pain inventory(BPI)score,nerve conduction velocities of the limbs,and traditional Chinese medicine(TCM)symptom scores before treatment,at the 21st day of the first cycle of chemotherapy(D1),and the 21st day of the second chemotherapy cycle(D2).The clinical efficacy was assessed at D2.Results:The incidence of CIPN was 92.5%in the control group,higher than 75.0%in the observation group(P<0.05).At D2,the number of people graded 0 on Levi’s specific sensory neurotoxicity grading was larger in the observation group than in the control group,and the number of those graded 2 was smaller in the observation group(P<0.05);the observation group had a higher markedly effective rate than the control group(P<0.05).At D2,the BPI general score,BPI pain intensity score,and BPI pain interference score significantly dropped in the observation group compared to those before treatment(P<0.05).At D1,the motor nerve conduction velocity(MNCV)and sensory nerve conduction velocity(SNCV)of the limbs decreased in both groups compared to those before treatment;at D2,the MNCV and SNCV increased in the two groups compared to D1 and were higher in the observation group than in the control group(P<0.05).At D1,the TCM symptom scores increased in both groups compared to those before treatment,and the observation group was lower than the control group in comparing the scores of numbness in the extremities and poor appetite(P<0.05).At D2,the observation group showed decreases in all TCM symptom scores compared to D1 except for the scores of nausea and vomiting and poor appetite(P<0.05),while the control group had no significant changes in the TCM symptom scores compared to D1(P>0.05);the observation group was lower than the control group in comparing each symptom score(P<0.05).There were no significant adverse reactions in either group over the study period.Conclusion:Compared to oral administration of methylcobalamin dispersible tablets,warming needle therapy shows certain strengths in managing CIPN after albumin-bound paclitaxel plus cisplatin chemotherapy,and it can better improve chemotherapy-induced gastrointestinal reactions.
目的:观察温针灸对白蛋白结合型紫杉醇联合顺铂化疗后周围神经病变的预防及治疗作用。方法:将80例患癌后接受白蛋白结合型紫杉醇联合顺铂化疗的患者采用简单随机分配表法分为观察组和对照组,每组40例。对照组予以甲钴胺分散片口服,观察组接受温针灸治疗。分别于治疗前、第1周期化疗的第21 d(D1)、第2周期化疗的第21 d(D2)对两组的化疗诱导的外周神经毒性(CIPN)发病情况、Levi专用感觉神经毒性分级、简明疼痛量表(BPI)、四肢神经传导速度进行评定,并进行中医症状评分。D2时评价临床疗效。结果:对照组CIPN发病率为92.5%,高于观察组的75.0%(P<0.05)。D2时,观察组Levi专用感觉神经毒性分级为0级的人数多于对照组,为2级的人数明显少于对照组(P<0.05);观察组临床显效率高于对照组(P<0.05)。D2时,观察组BPI总评分、BPI疼痛强度评分及BPI疼痛影响评分显著低于治疗前(P<0.05)。D1时,两组患者四肢运动神经传导速度(MNCV)及感觉神经传导速度(SNCV)均较治疗前下降;D2时,两组患者四肢MNCV及SNCV均较本组D1时提高,且观察组高于对照组(P<0.05)。D1时,两组患者各中医症状评分均较治疗前增加;观察组手足麻木、纳差评分低于对照组(P<0.05)。D2时,观察组除恶心呕吐及纳差评分外,其余症状评分均较D1时下降(P<0.05),而对照组各症状评分与D1时均无统计学差异(P>0.05);观察组各症状评分均低于对照组(P<0.05)。研究期间两组均未出现严重不良反应。结论:与口服甲钴胺分散片相比,温针灸对降低白蛋白结合型紫杉醇联合顺铂化疗后CIPN的发生具有一定优势,且能更好地改善化疗后胃肠道反应。
基金
重庆市科卫联合中医药技术创新与技术发展项目,No.2021ZY3571
重庆市科卫联合中医药科技项目,No.ZY201802029。
