發(fā)布時(shí)間：2018-01-30 20:30

  本文關(guān)鍵詞： 黃芪桂枝五物湯 奧沙利鉑 神經(jīng)毒性 肌電圖　出處：《南京中醫(yī)藥大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:通過觀察黃芪桂枝五物湯化裁方對惡性腫瘤患者化療后外周神經(jīng)毒性癥狀分級、化療前后肌電圖等指標(biāo)的影響,評價(jià)其臨床綜合療效,從而為惡性腫瘤患者化療后毒副反應(yīng)的防治手段提供可靠的臨床數(shù)據(jù)和臨床基礎(chǔ),增加提高化療患者生活質(zhì)量的手段。方法:采用前瞻性、隨機(jī)對照的臨床研究方法。選取樣本量66例,使用隨機(jī)區(qū)組設(shè)計(jì)方案,以患者入組時(shí)間作為配伍因素,將入院后擬行FOLFOX6化療方案并符合納入標(biāo)準(zhǔn)的惡性腫瘤患者入組并進(jìn)行分組,分為治療組(中藥+化療)33例和對照組(單純化療)33例,治療組患者從第一次化療開始口服中藥,以黃芪桂枝五物湯為主方化裁,持續(xù)至六個(gè)周期化療結(jié)束,對照組采用單純化療;研究所需收集的數(shù)據(jù)包括患者化療后的外周神經(jīng)毒性癥狀,第一次化療前和六周期化療結(jié)束后各條神經(jīng)的運(yùn)動(dòng)神經(jīng)傳導(dǎo)速度(MNCV)與感覺神經(jīng)傳導(dǎo)速度(SCV),以及各項(xiàng)安全性指標(biāo),最后將數(shù)據(jù)進(jìn)行分析總結(jié)。結(jié)果:1、治療組外周神經(jīng)毒性癥狀及體征的發(fā)生率明顯小于對照組,且臨床表現(xiàn)較對照組輕微(P0.01);2、化療前后運(yùn)動(dòng)神經(jīng)傳導(dǎo)速度(MNCV)呈下降趨勢,治療組左側(cè)尺神經(jīng)、左側(cè)腓神經(jīng)有統(tǒng)計(jì)學(xué)差異(P0.05),左側(cè)正中神經(jīng)、右側(cè)正中神經(jīng)、右側(cè)尺神經(jīng)、右側(cè)腓神經(jīng)無統(tǒng)計(jì)學(xué)差異(P0.05);對照組化療前后左側(cè)正中神經(jīng)、右側(cè)正中神經(jīng)、左側(cè)尺神經(jīng)、右側(cè)尺神經(jīng)有統(tǒng)計(jì)學(xué)差異(P0.05),右側(cè)尺神經(jīng)、右側(cè)腓神經(jīng)無統(tǒng)計(jì)學(xué)差異(P0.05);3、化療后運(yùn)動(dòng)神經(jīng)傳導(dǎo)速度(MNCV)比較,右側(cè)正中神經(jīng)組間比較有統(tǒng)計(jì)學(xué)差異(P0.05),左側(cè)尺神經(jīng)化療前后差值組間比較無統(tǒng)計(jì)學(xué)差異(P0.05),余神經(jīng)組間比較無統(tǒng)計(jì)學(xué)差異(P0.05);若綜合運(yùn)動(dòng)神經(jīng)的數(shù)據(jù),化療前后比較無統(tǒng)計(jì)學(xué)差異(P0.05),化療后組間比較無統(tǒng)計(jì)學(xué)差異(P0.05)。4、對于感覺神經(jīng)傳導(dǎo)速度(SCV),化療前后呈下降趨勢,各條感覺神經(jīng)化療前后對比均有統(tǒng)計(jì)學(xué)差異(P0.01),兩組化療后數(shù)據(jù)對比有統(tǒng)計(jì)學(xué)差異(P0.01)。結(jié)論:黃芪桂枝五物湯化裁方在臨床上對奧沙利鉑化療所致外周神經(jīng)毒性的預(yù)防與治療是有意義的,能夠防止化療外周神經(jīng)毒性的發(fā)生及加重。
[Abstract]:Objective: to observe the effect of Huangqi Guizhi Wuwu decoction on the classification of peripheral neurotoxic symptoms and electromyography (EMG) in patients with malignant tumor after chemotherapy. So as to provide reliable clinical data and clinical basis for the prevention and treatment of side effects after chemotherapy in patients with malignant tumor, and increase the means to improve the quality of life of patients with chemotherapy. A randomized controlled clinical study was conducted. 66 samples were selected and randomized block design was used. The time of patients entering the group was taken as the compatibility factor. Patients with malignant tumor were divided into treatment group (33 cases of traditional Chinese medicine chemotherapy group) and control group (33 cases of simple chemotherapy group). The patients in the treatment group began to take oral Chinese medicine from the first time of chemotherapy, with Huangqi Guizhi Wuwu decoction as the main cut, which lasted until the end of six cycles of chemotherapy, while the control group was treated with simple chemotherapy. The data to be collected include peripheral neurotoxic symptoms after chemotherapy. The motor nerve conduction velocity (MNCVV) and sensory nerve conduction velocity (SCV) of each nerve before and after the first chemotherapy and the end of the six-cycle chemotherapy, as well as the safety indexes. Results the incidence of peripheral neurotoxic symptoms and signs in the treatment group was significantly lower than that in the control group, and the clinical manifestation was slightly higher than that in the control group (P 0.01). 2the motor nerve conduction velocity (MNCVV) decreased before and after chemotherapy. In the treatment group, the left ulnar nerve, the left peroneal nerve, the left median nerve and the right median nerve were significantly different. There was no statistical difference between the right ulnar nerve and the right peroneal nerve. In the control group, there were significant differences in left median nerve, right median nerve, left ulnar nerve and right ulnar nerve before and after chemotherapy. There was no statistical difference in the right peroneal nerve (P0.05). 3The motor nerve conduction velocity (MNCVV) after chemotherapy was significantly different between the right median nerve group (P 0.05). There was no statistical difference between the left ulnar nerve group and the left ulnar nerve group before and after chemotherapy. If the data of motor nerve were synthesised, there was no statistical difference before and after chemotherapy (P 0.05), but there was no significant difference between the groups after chemotherapy (P 0.05. 4) for sensory nerve conduction velocity (SCV). Before and after chemotherapy showed a downward trend, the comparison of each sensory nerve before and after chemotherapy were statistically different (P0.01). Conclusion: Huangqi Guizhi Wuwu decoction has significance in preventing and treating peripheral neurotoxicity induced by oxaliplatin chemotherapy. It can prevent the occurrence and aggravation of peripheral neurotoxicity in chemotherapy.
【學(xué)位授予單位】：南京中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R730.53

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 魏曉晨;朱立勤;王春革;鄧琦;李新;;3種中藥注射劑預(yù)防奧沙利鉑所致周圍神經(jīng)毒性的網(wǎng)狀Meta分析[J];中國醫(yī)院藥學(xué)雜志;2016年18期

2 魏曉晨;王慧;朱立勤;王春革;鄧琦;李新;;補(bǔ)陽還五湯預(yù)防奧沙利鉑所致周圍神經(jīng)毒性療效及安全性的系統(tǒng)評價(jià)[J];中國實(shí)驗(yàn)方劑學(xué)雜志;2016年22期

3 黃小華;劉葉;徐炎良;;FOLFOX6方案治療晚期結(jié)直腸癌的療效與安全性分析[J];實(shí)用癌癥雜志;2016年05期

4 魏曉晨;朱立勤;王春革;鄧琦;李新;;維生素類藥物預(yù)防化療致周圍神經(jīng)毒性的療效及安全性的Meta分析[J];中國現(xiàn)代應(yīng)用藥學(xué);2016年04期

5 蔡青;張文潔;趙舒武;王蓉;許蓬娟;賀美瑜;劉暢;肖杏;孫梓翔;;補(bǔ)陽還五湯對奧沙利鉑致神經(jīng)病理痛模型大鼠的干預(yù)作用[J];天津中醫(yī)藥;2016年03期

6 魏曉晨;王慧;朱立勤;王春革;鄧琦;李新;;當(dāng)歸四逆湯預(yù)防奧沙利鉑致周圍神經(jīng)系統(tǒng)毒性的Meta分析[J];山東醫(yī)藥;2016年05期

7 沈婕;何勝利;孫賢俊;胡南華;蔡蕓蕓;;加味黃芪桂枝五物湯外洗治療奧沙利鉑致周圍神經(jīng)病變臨床研究[J];中國中醫(yī)藥信息雜志;2015年11期

8 郭子寒;焦園園;范麗萍;張艷華;;5種干預(yù)措施預(yù)防奧沙利鉑致慢性神經(jīng)毒性療效的網(wǎng)狀Meta分析[J];中國藥房;2015年24期

9 丁蓉;霍介格;汪悅;;當(dāng)歸四逆湯防治奧沙利鉑周圍神經(jīng)毒性的臨床觀察[J];南京中醫(yī)藥大學(xué)學(xué)報(bào);2014年05期

10 于濱;蘇智祥;袁媛;吳敏慧;;黃芪桂枝五物湯加減防治TP方案化療引起神經(jīng)毒性的療效觀察[J];成都中醫(yī)藥大學(xué)學(xué)報(bào);2014年02期

，

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