Yoon Jeungwon, Jeon Ju-Hyun, Lee Yeon-Weol, Cho Chong-Kwan, Kwon Ki-Rok, Shin Ji-Eun, Sagar Stephen, Wong Raimond, Yoo Hwa-Seung
East-West Cancer Center, Dunsan Oriental Hospital of Daejeon University, Daejeon, Korea.
J Acupunct Meridian Stud. 2012 Aug;5(4):156-65. doi: 10.1016/j.jams.2012.05.003. Epub 2012 Jun 16.
Chemotherapy-induced peripheral neuropathy (CIPN) is sensory and motor nerve damage to the peripheral nervous system caused by chemotherapeutic agents. It often causes pain and other varying degrees of neuropathic symptoms accompanied by functional limitations and reduced quality of life. Currently, there is no standard treatment protocol for the treatment of CIPN.
In need of more research to develop new therapeutic options focusing on their safety, efficacy, and long-term sustained clinical effects, a pilot study of sweet bee venom pharmacopuncture (SBVP) for CIPN was conducted to build up preliminary efficacy data in the process of preparing for a future larger scale randomized controlled SBVP trial for CIPN.
We conducted a prospective case series by analyzing the clinical observations made of CIPN patients treated with SBVP. A total of 11 eligible consecutive CIPN patients who visited East-West Cancer Center from June 1, 2010, to February 28, 2011, were treated with total of six SBVP treatments given within the 3-week period. The outcomes were measured using World Health Organization Common Toxicity Criteria for Peripheral neuropathy (WHO grading system), Patient Neurotoxicity Questionnaire (PNQ), Visual Analogue System (VAS), and Health-Related Quality of Life (HRQOL) collected at the baseline, post-second, fourth, and the final treatment. Patients were followed 3 weeks into no intervention to determine the sustained effects of pharmacopuncture.
Both of the WHO CIPN grade and PNQ scores have shown a decrease in the level of neuropathy. VAS pain level has also shown a great decrease and improvement in patients' quality of life have also been detected though modest. Changes in WHO grade, VAS and Total HRQOL scores between the baseline and after the last treatment session were significant. Changes in WHO grade, Total PNQ, PNQ-sensory, VAS, Total HRQOL, and HRQOL-functional scores between the baseline and the 3-week follow-up were significant.
The positive result of the study supports the potential value of conducting a fully powered trial to explore further efficacy of SBVP for CIPN. However a single positive result within this pilot study must be interpreted with caution.
化疗引起的周围神经病变（CIPN）是化疗药物对周围神经系统造成的感觉和运动神经损伤。它常引发疼痛及其他不同程度的神经病变症状，伴有功能受限和生活质量下降。目前，尚无治疗CIPN的标准治疗方案。
由于需要更多研究来开发注重安全性、有效性和长期持续临床效果的新治疗选择，因此开展了一项关于甜蜂毒穴位注射（SBVP）治疗CIPN的试点研究，以便在为未来更大规模的CIPN随机对照SBVP试验做准备的过程中积累初步疗效数据。
我们通过分析接受SBVP治疗的CIPN患者的临床观察结果进行了一项前瞻性病例系列研究。2010年6月1日至2011年2月28日期间，共有11例符合条件的连续CIPN患者前往东西方癌症中心就诊，在3周内共接受了6次SBVP治疗。使用世界卫生组织周围神经病变通用毒性标准（WHO分级系统）、患者神经毒性问卷（PNQ）、视觉模拟量表（VAS）以及在基线、第二次、第四次和最后一次治疗时收集的健康相关生活质量（HRQOL）来衡量结果。在不进行干预的情况下对患者进行3周随访，以确定穴位注射的持续效果。
WHO CIPN分级和PNQ评分均显示神经病变程度有所降低。VAS疼痛水平也显著下降，并且患者的生活质量也有改善，尽管改善程度不大。基线与最后一次治疗后WHO分级、VAS和总HRQOL评分的变化具有显著性。基线与3周随访之间WHO分级、总PNQ、PNQ-感觉、VAS、总HRQOL和HRQOL-功能评分的变化具有显著性。
该研究的阳性结果支持进行一项充分有力的试验以进一步探索SBVP治疗CIPN疗效的潜在价值。然而，对于该试点研究中的单个阳性结果必须谨慎解读。
