加味黄芪桂枝五物汤治疗奥沙利铂慢性外周神经毒性的临床效果

doi:10.20047/j.issn1673-7210.2023.10.27

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摘要目的观察加味黄芪桂枝五物汤治疗奥沙利铂慢性外周神经毒性的临床效果。方法按照随机数字表法将2019年1月至2022年3月南京中医药大学附属盐城市中医院肿瘤科收治的46例奥沙利铂导致的慢性外周神经毒性的结直肠癌患者，将其分为对照组和观察组，各23例。对照组单纯化疗，治疗组在对照组的基础上配合加味黄芪桂枝五物汤颗粒，共治疗6个月。观察治疗前后两组化疗致外周神经毒性（CIPN20）评分、卡氏功能状态（KPS）评分、通用不良事件术语标准4.0版（血液毒性、消化道反应、肝肾功能）。结果治疗后，两组CIPN20评分较治疗前升高，KPS评分较治疗前降低（P＜0.05），且治疗组CIPN20评分低于对照组，KPS评分高于对照组（P＜0.05）；观察组白细胞、血红蛋白、血小板分级优于对照组，但治疗后两组恶心、呕吐、腹泻、谷丙转氨酶升高、谷草转氨酶升高发生率比较，差异无统计学意义（P＞0.05）。结论加味黄芪桂枝五物汤在临床应用可治疗奥沙利铂慢性外周神经毒性，提高患者生活质量，减轻化疗导致骨髓抑制，且安全可靠。

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	陈晨1 马海龙2 顾银霞1 成玲玲1 岳伟1 马霜1 吴晓静1 徐建林1

关键词 ：加味黄芪桂枝五物汤, 化疗, 奥沙利铂, 慢性外周神经毒性

Abstract：Objective To observe clinical effect of modified Huangqi Guizhi Wuwu Decoction in the treatment of peripheral neurotoxicity induced by oxaliplatin. Methods According to the random number table method, 46 peripheral neurotoxicity induced by Oxaliplatin with colorectal cancer patients admitted to the Department of Oncology, Yancheng Traditional Chinese Medicine Hospital Affiliated to Nanjing University of Chinese Medicine from January 2019 to March 2022 were divided into control and treatment group, with 23 cases in each group. The control group was treated with chemotherapy alone, and the treatment group was treated with Huangqi Guizhi Wuwu Decoction Granules based on the control group, for a total of 6 months. Chemotherapy-induced peripheral neurotoxicity 20 (CIPN) 20 score, Karnofsky performance state (KPS) score, general adverse event terminology standard 4.0 (blood toxicity, digestive tract reaction, liver, and kidney function) were observed in two groups before and after treatment. Results After treatment, CIPN20 score was higher than before treatment, and KPS score was lower than before treatment (P＜0.05), and CIPN20 score in the treatment group was lower than the control group, and KPS score was higher than those in control group (P＜0.05). The elassificatim of leukocyte, hemoglobin, and platele in the observation group was better than that in the control group, but there was no significant difference in the incidence of nausea, vomiting, diarrhea, elevated alanine aminotransferase, and oxalacetic aminotransferase between the two groups after treatment (P＞0.05). Conclusion Modified Huangqi Guizhi Wuwu Decoction can effectively treat the peripheral neurotoxicity induced by oxaliplatin, improve the patient’s quality of life, and reduce myelosuppression, which is safe and reliable.

Key words： Modified Huangqi Guizhi Wuwu Decoction Chemotherapy Oxaliplatin Chronic peripheral neurotoxicity

基金资助:国家中医临床研究基地（江苏省中医药研究院）开放课题（JD2019SZXYB16）；
国家中医药管理局全国中医药创新骨干人才培训项目（国中医药人教函〔2019〕128号）。

通讯作者: 徐建林（1981-），男，博士，副主任医师；研究方向：中医肿瘤学。

作者简介: 陈晨（1988-），女，硕士；研究方向：中医肿瘤学。

引用本文:

陈晨1 马海龙2 顾银霞1 成玲玲1 岳伟1 马霜1 吴晓静1 徐建林1. 加味黄芪桂枝五物汤治疗奥沙利铂慢性外周神经毒性的临床效果[J]. 中国医药导报, 2023, 20(10): 122-125.
CHEN Chen1 MA Hailong2 GU Yinxia1 CHENG Lingling1 YUE Wei1 MA Shuang1 WU Xiaojing1 XU Jianlin1. Clinical effect of modified Huangqi Guizhi Wuwu Decoction in the treatment of peripheral neurotoxicity induced by Oxaliplatin. 中国医药导报, 2023, 20(10): 122-125.

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[1] Soveri LM，Lamminmk A，Hnninen UA，et al. Long-term neuropathy and quality of life in colorectal cancer patients treated with oxaliplatin containing adjuvant chemotherapy [J]. Acta Oncol，2019，58（4）：398-406.
[2] Argyriou AA. Updates on oxaliplatin-induced peripheral，neurotoxicity （OXAIPN） [J]. Toxics，2015，3（2）：187-197.
[3] Palugulla S，Dkhar SA，Kayal S，et al. Oxaliplatin-induced peripheral neuropathy in south Indian cancer patients：a prospective study in digestive tract cancer patients [J]. Indian J Med Paediatr Oncol，2017，38（4）：502-507.
[4] Staff NP，Cavaletti G，Islam B，et al. Platinum-induced peripheral neurotoxicity：From pathogenesis to treatment [J]. J Peripher Nerv Syst，2019，24（2）：S26-S39.
[5] 曹鹏，李松林，霍介格.奥沙利铂相关性周围神经病变以血痹论治[J].中国中医基础医学杂志，2013，19（4）：430-431.
[6] 李丹，孙焱，曹雯，等.基于关联规则和复杂系统熵聚类研究中药治疗奥沙利铂神经毒性的组方规律研究[J].世界科学技术—中医药现代化，2019，21（7）：1841-1847.
[7] 中华人民共和国卫生部.中国常见恶性肿瘤诊治规范[M]. 北京：北京医科大学、中国协和大学联合出版社，1991.
[8] Li T，Park SB，Battaglini E，et al. Assessing chemotherapy-induced peripheral neuropathy with patient reported outcome measures：a systematic review of measurement properties and considerations for future use [J]. Qual Life Res，2022， 31（11）：3091-3107.
[9] Gu Z，Wei G，Zhu L，et al. Preventive Efficacy and Safety of Yiqi-Wenjing-Fang Granules on Oxaliplatin-Induced Peripheral Neuropathy：A Protocol for a Randomized，Double-Blind，Placebo-Controlled，Multicenter Trial [J]. Evid Based Complement Alternat Med，2021，2021：5551568.
[10] 巩雅宁，王帅，张静，等.黄芪多糖对老年肺癌患者化疗期间骨髓抑制的改善作用及造血干细胞的影响[J].海南医学院学报，2020，26（19）：1468-1473.
[11] 丁欢，吴承杰，潘娅岚，等.黄芪及当归改善化疗后骨髓抑制的分子机制研究进展[J].中国医药导报，2020，17（5）：23-26.
[12] 马艳春，吴文轩，胡建辉，等.当归的化学成分及药理作用研究进展[J].中医药学报，2022，50（1）：111-114.
[13] 吕孙建，焦锦彪，刘莉，等.白芍（Radix paeoniae alba）提取物对中华绒螯蟹（Eriocheir sinensis）造血组织发育及造血因子Astakine的影响[J].海洋与沼，2021，52（3）：754- 761.
[14] 陈熹，李玉洁，杨庆，等.大枣现代研究开发进展与展望[J].世界科学技术-中医药现代化，2015，17（3）：687-691.
[15] 陈晨.黄芪桂枝五物汤对奥沙利铂致神经病理性疼痛大鼠钠离子通道蛋白及基因表达的影响[D].南京：南京中医药大学，2014.
[16] Sittl R，Lampert A，Huth T，et al. Anticancer drug oxaliplatin induces acute cooling-aggravated neuropathy via sodium channel subtype Na（V）1.6-resurgent and persistent current [J]. Proc Natl Acad Sci U S A，2012，109（17）：6704-6709.
[17] Kagiava A，Tsingotjidou A，Emmanouilides C，et al. The effects of oxaliplatin，an anticancer drug，on potassium channels of the peripheral myelinated nerve fibres of the adult rat [J]. Neurotoxicology，2008，29（6）：1100-1106.
[18] Furga?覥a A，Fija?覥kowski ?覵，Nowaczyk A，et al. Time-shifted co-administration of sub-analgesic doses of ambroxol and pregabalin attenuates oxaliplatin-induced cold allodynia in mice [J]. Biomed Pharmacother，2018，106：930-940.
[19] 丁蓉，汪悦，霍介格，等.当归四逆汤对奥沙利铂神经毒性大鼠背根神经节TRPs通道的影响[J].南京中医药大学学报，2019，35（2）：189-193.
[20] Wei G，Gu Z，Gu J，et al. Platinum accumulation in oxaliplatin-induced peripheral neuropathy [J]. J Peripher Nerv Syst，2021，26（1）：35-42.
[21] 魏国利，顾展丞，李灵常，等.黄芪桂枝五物汤减少铂蓄积预防奥沙利铂慢性外周神经毒性机制研究[J].世界科学技术—中医药现代化，2019，21（7）：1467-1473.
[22] Avan A，Postma TJ，Ceresa C，et al. Platinum-induced neurotoxicity and preventive strategies：past，present，and future [J]. Oncologist，2015，20（4）：411-432.
[23] McWhinney SR，Goldberg RM，McLeod HL. Platinum neurotoxicity pharmacogenetics [J]. Mol Cancer Ther，2009，8（1）：10-16.
[24] Podratz JL，Knight AM，Ta LE，et al. Cisplatin induced mitochondrial DNA damage in dorsal root ganglion neurons [J]. Neurobiol Dis，2011，41（3）：661-668.
[25] Janes K，Wahlman C，Little JW，et al. Spinal neuroimmune activation is independent of T-cell infltration and attenuated by A3 adenosine receptor agonists in a model of oxaliplatin-induced peripheral neuropathy [J]. Brain Behav Immun，2015，44：91-99.
[26] Shen S，Lim G，You Z，et al. Gut microbiota is critical for the induction of chemotherapy-induced pain[J]. Nat Neurosci，2017，20（9）：1213-1216.
[27] Gu JL，Wei GL，Ma YZ，et al. Exploring the Possible Mechanism and Drug Targets of Huang-Qi-Gui-Zhi-Wu-Wu Decoction for the Treatment of Chemotherapy-Induced Peripheral Neuropathy on Network Pharmacology [J]. Evid Based Complement Alternat Med [J]. 2020，2020：2363262.