Han Xiaoyan, Wang Lijuan, Shi Hongfei, Zheng Gaofeng, He Jingsong, Wu Wenjun, Shi Jimin, Wei Guoqing, Zheng Weiyan, Sun Jie, Huang He, Cai Zhen
Multiple Myeloma Center, Bone Marrow Transplantation Center, Department of Hematology, The First Affiliated Hospital, School of Medicine, Zhejiang University, No. 79 Qingchun Road, Hangzhou, 310003, China.
Present Address: Department of Hematology, Hematology Laboratory, Linyi People's Hospital, Shandong University, Linyi, 276002, China.
BMC Cancer. 2017 Jan 9;17(1):40. doi: 10.1186/s12885-016-3037-z.
Chemotherapy-induced peripheral neuropathy (CIPN) seriously affects the quality of life of patients with multiple myeloma (MM) as well as the response rate to chemotherapy. Acupuncture has a potential role in the treatment of CIPN, but at present there have been no randomized clinical research studies to analyze the effectiveness of acupuncture for the treatment of CIPN, particularly in MM patients.
The MM patients (104 individuals) who met the inclusion criteria were randomly assigned into a solely methylcobalamin therapy group (500 μg intramuscular methylcobalamin injections every other day for 20 days; ten injections) followed by 2 months of 500 μg oral methylcobalamin administration, three times per day) and an acupuncture combined with methylcobalamin (Met + Acu) group (methylcobalamin used the same way as above accompanied by three cycles of acupuncture). Of the patients, 98 out of 104 completed the treatment and follow-ups. There were 49 patients in each group. The evaluating parameters included the visual analogue scale (VAS) pain score, Functional Assessment of Cancer Therapy/Gynecologic Oncology Group-Neurotoxicity (Fact/GOG-Ntx) questionnaire scores, and electromyographic (EMG) nerve conduction velocity (NCV) determinations. We evaluated the changes of the parameters in each group before and after the therapies and made a comparison between the two groups.
After 84 days (three cycles) of therapy, the pain was significantly alleviated in both groups, with a significantly higher decrease in the acupuncture treated group (P < 0.01). The patients' daily activity evaluated by Fact/GOG-Ntx questionnaires significantly improved in the Met + Acu group (P < 0.001). The NCV in the Met + Acu group improved significantly while amelioration in the control group was not observed.
The present study suggests that acupuncture combined with methylcobalamin in the treatment of CIPN showed a better outcome than methylcobalamin administration alone.
China Clinical Trials Register (registration no. ChiCTR-INR-16009079 , registration date August 24, 2016).
化疗引起的周围神经病变（CIPN）严重影响多发性骨髓瘤（MM）患者的生活质量以及化疗反应率。针灸在CIPN治疗中具有潜在作用，但目前尚无随机临床研究分析针灸治疗CIPN的有效性，尤其是在MM患者中。
将符合纳入标准的MM患者（104例）随机分为单纯甲钴胺治疗组（每2天肌肉注射500μg甲钴胺，共20天；10次注射），随后2个月每天口服500μg甲钴胺，每日3次）和针灸联合甲钴胺（Met+Acu）组（甲钴胺用法同上，同时进行3个周期的针灸治疗）。104例患者中，98例完成了治疗和随访。每组49例患者。评估参数包括视觉模拟量表（VAS）疼痛评分、癌症治疗功能评估/妇科肿瘤学组神经毒性（Fact/GOG-Ntx）问卷评分以及肌电图（EMG）神经传导速度（NCV）测定。我们评估了每组治疗前后参数的变化并对两组进行了比较。
治疗84天（3个周期）后，两组疼痛均显著缓解，针灸治疗组疼痛缓解程度明显更高（P＜0.01）。通过Fact/GOG-Ntx问卷评估，Met+Acu组患者的日常活动明显改善（P＜0.001）。Met+Acu组的NCV显著改善，而对照组未观察到改善。
本研究表明，针灸联合甲钴胺治疗CIPN的效果优于单纯使用甲钴胺。
中国临床试验注册中心（注册号：ChiCTR-INR-16009079，注册日期：2016年8月24日）
