张毅鹏

[摘要] 目的 观察加味阳和汤防治奥沙利铂神经毒性的临床疗效。 方法 将60例符合纳入标准的结直肠癌患者随机分为治疗组和对照组，各30例。两组均给予含奥沙利铂的化疗方案进行化疗，治疗组化疗同时加用加味阳和汤，各组均以21 d为1个周期，共治疗4个周期，观察治疗后两组患者神经毒性发生率和程度及血流动力学改变。 结果 治疗后治疗组神经系统毒性的发生率明显低于对照组，差异有统计学意义（P<0.05）；治疗后两组血流动力学指标均较治疗前明显改善，差异有统计学意义（P<0.05）；治疗组三项指标均低于对照组，差异有统计学意义（P<0.05）。 结论 加味阳和汤对奥沙利铂导致的神经系统毒性可有效改善患者血液动力学指标，而且可以预防和降低其周围神经毒性。

[关键词] 加味阳和汤；奥沙利铂；神经毒性；防治

[中图分类号] R277.7 [文献标识码] B [文章编号] 1673-9701（2018）15-0124-03

Observation of the clinical efficacy of Jiawei Yanghe Decoction on prevention of the neurotoxicity of oxaliplatin

ZHANG Yipeng

Department of Oncology， Qinhuangdao Hospital of Traditional Chinese Medicine， Qinhuangdao 066001， China

[Abstract] Objective To observe the clinical efficacy of Jiawei Yanghe Decoction on prevention of the neurotoxicity of oxaliplatin. Methods 60 patients with colorectal cancer who met the inclusion criteria were randomLy divided into treatment group and control group with 30 cases in each group. The two groups were both given chemotherapy with oxaliplatin， and the treatment group added Jiawei Yanghe Decoction. For the two groups，1 cycle included 21 days and they both received the treatments for 4 cycles. The incidence rate and the degree of neurotoxicity and the hemodynamic changes in the two groups after treatment were observed. Results The incidence rate of neurotoxicity in the treatment group was significantly lower than that in the control group（P<0.05）. The hemodynamic indexes of the two groups were significantly improved after treatment（P<0.05）， and the three indexes in the treatment group were lower than those in the control group with the differences being statistically significant（P<0.05）. Conclusion Jiawei Yanghe Decoction has effect on prevention of the neurotoxicity of oxaliplatin， which improves the hemodynamic index and prevents and reduces the peripheral neurotoxicity.

[Key words] Jiawei Yanghe Decoction； Oxaliplatin； Neurotoxicity； Prevention

奧沙利铂（Oxaliplatin，L-OHP）是临床上常用的第三代铂类抗肿瘤药物，临床上主要用于消化道肿瘤的化学治疗[1]。急慢性的神经毒性是奥沙利铂最常见的不良反应[2]。神经系统毒性的急性发作一般是在给药后1～2 d内快速出现，而神经系统毒性的慢性发作则常常在多周期的治疗后出现，呈现为一种逐渐进展的过程，慢性神经毒性主要表现为手足及口周麻木、疼痛及感觉异常或迟钝，严重时导致肢体功能障碍进而导致患者日常生活质量下降[3]。有些患者的神经系统毒性恢复时间比较长，严重患者无法恢复，需减少奥沙利铂药量甚至停止使用，这样很可能影响化疗治疗效果。目前针对其神经系统毒性反应，尚未发现具有肯定疗效的预防措施和治疗药物。近年来，笔者用加味阳和汤防治奥沙利铂所导致的神经系统毒性，在临床应用中取得良好的疗效，现报道如下。……