Department of Tradition Chinese Medicine, Qingpu Branch of Zhongshan Hospital, Fudan University, Shanghai 201700, China.
Department of Oncology, Shanghai Qingpu District Hospital of Traditional Chinese Medicine (the Clinical Base of The Institutes of Integrative Medicine, Fudan University), Shanghai 201799, China.
J Tradit Chin Med. 2023 Oct;43(6):1234-1242. doi: 10.19852/j.cnki.jtcm.20230630.004.
To analyze the distribution characteristics of Traditional Chinese Medicine (TCM) syndromes in patients with oxaliplatin-induced peripheral neuropathy (OIPN) and observe the clinical efficacy of Bushen Yiqi formula (, BSYQF) in treating patients with OIPN.
A total of 89 patients with OIPN were enrolled in this study. The TCM syndrome characteristics were investigated by frequency analysis methodology after collecting and analyzing the TCM syndrome elements of the patients with the OIPN TCM syndrome element scale. Further, 62 cases of cold-dampness obstruction syndrome and kidney deficiency and cold syndrome were selected and randomly divided into the control group ( 31) and the treatment group ( 31). The patients in the treatment group were treated with modified BSYQF, while those in the control group were treated with mecobalamin tablets for 3 weeks. The Levi sensory neurotoxicity score and the neuro-electrophysiological changes were observed before and after the treatment in both groups.
The distribution of TCM syndrome types in 89 patients with OIPN were in order of kidney deficiency and cold syndrome (44 cases), cold-dampness obstruction syndrome (18 cases), deficiency of liver and kidney syndrome (11 cases), blood stasis obstruction syndrome (7 cases), and dampness-heat obstruction syndrome (5 cases). Improvement in Levi sensory neurotoxicity score: After 3-week treatment, the total effective rate in the treatment group was higher than that in the control group ( 0.05). The subgroup analysis showed that the total effective rate in the treatment group of patients with kidney deficiency and cold syndrome was higher than that in the control group before and after treatment ( 0.05). Improvement in nerve conduction velocity: The sensory nerve conduction velocity of bilateral ulnar nerves improved in the control group after treatment compared with that before treatment ( 0.05). The sensory and motor nerve conduction velocities of the bilateral ulnar and bilateral peroneal nerves improved in the treatment group compared with those before treatment and after treatment in the control group ( 0.05).
The modified BSYQF had a definite therapeutic effect on the OIPN in patients with kidney deficiency and cold syndrome and those with cold-dampness obstruction syndrome. It could effectively reduce the grade of peripheral nerve toxicity and improve nerve conduction velocity, and its curative effect was better than that of mecobalamin tablets.
分析奥沙利铂引起的周围神经病变(OIPN)患者的中医证候分布特点,并观察补肾益气方治疗 OIPN 的临床疗效。
共纳入 89 例 OIPN 患者,采用频数分析方法,收集并分析 OIPN 中医证候要素量表患者的中医证候要素,得出 OIPN 患者的中医证候特点。进一步选取寒湿阻络证和肾虚寒凝证患者 62 例,随机分为对照组(31 例)和治疗组(31 例)。治疗组给予加味补肾益气方,对照组给予甲钴胺片治疗,疗程均为 3 周。观察两组患者治疗前后 Levi 感觉神经毒性评分及神经电生理变化。
89 例 OIPN 患者中医证型分布以肾虚寒凝证(44 例)、寒湿阻络证(18 例)、肝肾两虚证(11 例)、血瘀络阻证(7 例)、湿热阻络证(5 例)为主。Levi 感觉神经毒性评分改善:治疗 3 周后,治疗组总有效率高于对照组(P<0.05)。亚组分析显示,治疗组肾虚寒凝证患者治疗前后总有效率均高于对照组(P<0.05)。神经传导速度改善:对照组治疗后双侧尺神经感觉神经传导速度较治疗前改善(P<0.05)。治疗组治疗后双侧尺神经、双侧腓总神经感觉及运动神经传导速度均较治疗前及对照组治疗后改善(P<0.05)。
加味补肾益气方治疗肾虚寒凝证和寒湿阻络证 OIPN 患者有一定疗效,能有效降低周围神经毒性分级,改善神经传导速度,疗效优于甲钴胺片。