节点文献
中药防治化疗药草酸铂的周围神经毒性的临床观察
【作者】 李京华；
【导师】 崔慧娟；
【作者基本信息】 北京中医药大学 ， 中西医结合内科学， 2008， 硕士
【摘要】 本论文包括文献综述和临床研究两部分。文献综述的题目为中西医治疗草酸铂神经毒性,回顾了近年来国内外对草酸铂周围神经毒性的基础及临床研究进展,主要从临床表现、发生机制及中西医治疗进展方面进行了论述。综合分析,草酸铂致周围神经毒性是其主要的不良反应,影响患者的生活质量并可能造成停药或减量,已受到国内外诸多学者的广泛关注,通过临床观察证明,中药在预防和治疗草酸铂周围神经毒性方面有一定的疗效。临床研究部分,观察了中药在防治化疗药草酸铂致周围神经毒性方面的疗效。目的:观察测量用草酸铂治疗胃癌、大肠癌的化疗中加用中药以减轻神经系统毒副反应的效果。方法:选择确诊为胃癌或大肠癌的患者,采用随机自身交叉对照的方法将化疗患者随机分为AB和BA两组,每例患者连续观察两个化疗周期,A周期为化疗的同时服用中药,每日早晚各一次,连续服用7天;B周期为单纯化疗。观察患者外周感觉神经毒性表现并测量了神经生长因子(NGF)。结果:共观察了73例患者,治疗组周围神经毒性的发生率为82.2%(60/73),且多为Ⅰ～Ⅱ级,少有Ⅲ级,没有Ⅳ级;对照组的发生率为87.7%(64/73),两组相比,治疗组具有明显优势(P<0.05)。共测得14例患者的血清NGF值,化疗后患者的血清NGF下降率明显低于对照组,两者具有统计学差异(P<0.05)。结论:中药对防治草酸铂化疗所引起的神经毒性反应有一定疗效,值得临床进一步研究及推广。
【Abstract】 The paper consists of two parts: a literature review and a clinical research.The literature review is about the advances in the treatment of peripheral neurotoxicity caused by Oxaliplatin in recent years. It includes clinical symptoms, mechanisms and the advances in management of Oxaliplatin-induced neurotoxicity with TCM and Western Medicine. Aggregate analysis, peripheral neurotoxicity caused by Oxaliplatin is its main side effect and influence the patients’quality of life. According to the clinical observation, it proved that TCM is efficient in prevention and treatment of Oxaliplatin-induced neurotoxicity.The second part is a clinical study. Objective: To investigate the effects of TCM in the treatment of peripheral neurotoxicity caused by Oxaliplatin. Methods: All the patients were diagnosed from gastric carcinoma or colorectal carcinoma.The patients were divided into two groups randomly. Every patients received two cycles of Oxaliplatin-based chemotherapy. The patients in treatment group received both TCM and chemotherapy. The patients in control group received chemotherapy alone. The clinical symptoms of neurotoxicity were observed, and the level of NGF before and after chemotherapy were measured. Results: 73 patients were studied. The incidence rate of peripheral neurotoxicity are 82.2% (60/73) in treatment group and 87.7% (64/73) in control group. The difference between two groups is significant (P<0.05). In 14 patients the level of NGF were measured. The descent of NGF is less serious in treatment group than that in control group after chemotherapy. Conclusion: TCM is effective in prevention and treatment peripheral neurotoxicity caused by Oxaliplatin, which is worth of a further research in oncological clinic.