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[目的]观察荣筋方联合谷胱甘肽防治结直肠癌奥沙利铂累积性外周神经毒性疗效。[方法]使用随机平行对照方法,将60例住院患者按随机数字表法分为两组,每组30例。治疗期间避免饮食冷物、呼吸较冷空气、接触冷物体及金属等,防止诱发或加重神经毒性症状。均采用FOLFOX4化疗方案,化疗6周期(奥沙利铂85mg/(m2·d),静滴2h,d1;亚叶酸钙200mg/(m2·d),静滴2h,d 1、2;氟尿嘧啶400mg/(m2·d),静推d 1、2,600mg/(m2·d),静滴持续22h,d 1、2。每2周重复1次,2次为1周期)。对照组谷胱甘肽1500mg/m2,静滴,1次/d。治疗组荣筋方(炙黄芪30g,桂枝、白芍各15g,鸡血藤20g,白术、川芎、当归各15g,细辛3g,醋延胡索10g,全蝎3g,醋青皮、木瓜、怀牛膝各15g,甘草3g),水煎200mL,早晚口服,1剂/d,每次化疗结束后2天开始,连续5剂。若消化道反应明显,延至反应减轻再开始服用;谷胱甘肽使用同对照组。连续治疗24周为1疗程。观测慢性神经毒性分级、不良反应。治疗1疗程,判定疗效。[结果]治疗组Ⅰ级10例,Ⅱ级15例,Ⅲ级5例。对照组Ⅰ级3例,Ⅱ级16例,Ⅲ级11例。奥沙利铂化疗后神经毒性治疗组低于对照组(P<0.05)。[结论]荣筋方联合谷胱甘肽防治结直肠癌奥沙利铂累积性外周神经毒性,疗效满意。
[Objective] To observe the effect of Rongjinfang combined with glutathione in the prevention and treatment of cumulative peripheral neurotoxicity of oxaliplatin in colorectal cancer. [Methods] Using randomized parallel control method, 60 cases of inpatients were divided into two groups according to random number table method, 30 cases in each group. During treatment to avoid cold food, cold air, contact with cold objects and metals, to prevent or aggravate the symptoms of neurotoxicity. All patients were treated with FOLFOX4 chemotherapy for 6 cycles of chemotherapy (oxaliplatin 85mg / (m2 · d), intravenous infusion of 2h, d1; leucovorin 200mg / (m2 · d), intravenous infusion of 2h, d 1,2; / (m2 · d), static push d 1,2,600mg / (m2 · d), intravenous infusion for 22h, d 1,2. Repeat once every 2 weeks, 2 times for 1 cycle). Control group glutathione 1500mg / m2, intravenous infusion, 1 time / d. Treatment group Rongjin Fang (Sunburn Astragalus 30g, Guizhi, white peony root of the 15g, Millettia 20g, Atractylodes, Chuanxiong, Angelica 15g, Asarum 3g, vinegar corydalis 10g, scorpion 3g, vinegar green skin, papaya, cow Knee each 15g, licorice 3g), decoction 200mL, morning and evening oral, 1 / d, 2 days after the end of each chemotherapy for 5 consecutive doses. If the gastrointestinal reaction was significantly delayed until the reaction to reduce re-start taking; use of glutathione with the control group. Continuous treatment for 24 weeks for a course of treatment. Observed chronic neurotoxicity grade, adverse reactions. Treatment of a course of treatment to determine the efficacy. [Results] The treatment group Ⅰ grade 10 cases, Ⅱ grade 15 cases, Ⅲ grade 5 cases. Control group Ⅰ grade 3 cases, Ⅱ grade 16 cases, Ⅲ grade 11 cases. The neurotoxicity after oxaliplatin chemotherapy was lower than that of the control group (P <0.05). [Conclusion] Rongjinfang combined with glutathione in the prevention and treatment of colorectal cancer cumulative peripheral neurotoxicity of oxaliplatin, with satisfactory results.