The Clinical Observation Of External Using Hexue Tongbi Fang To Treat Peripheral Nerve Toxicity Caused By Anti-tumor Chemotherapy Drugs

Purpose:To analyses etiology and pathogenesis in TCM of peripheral nerve toxicity caused by anti-tumor chemotherapy drugs, then evaluate the treatment and security of external using Hexue Tongbi Fang to treat peripheral nerve toxicity caused by anti-tumor chemotherapy drugs, in order to provide relevant theoretical and practical reference in the Chinese medicine Standardized therapy of peripheral nerve toxicity caused by anti-tumor chemotherapy drugs.Methods:Using prospective and self-controlled research methods, collect a total of 40 cases, give the external using of Hexue Tongbi Fang to treat peripheral nerve toxicity caused by anti-tumor chemotherapy drugs. Then formulate a standard of peripheral nerve toxicity according to NCI, contrast the changes of peripheral nerve toxicity before and after treatment period and the onset time, for the sake of evaluating the efficafy of Chinese medicine.Results:①In 40 cases, the most common types of TCM syndrome is qi deficiency and blood deficiency Type(75%), then the most common grades of peripheral nerve toxicity is Grade 1(47.5%). Among them which used the chemotherapy drugs such as Taxol are most including blood deficiency syndrome, showing numb of distal limbs, diminished sense of sleeve-like. The patients which used the chemotherapy drugs such as Xeloda are most including blood heat syndrome, showing limb peripheral pigmentation and desquamation. The patients which used the chemotherapy drugs such as L-OHP are most including cold congealing syndrome, showing cold of the limbs and numb pain which may increase by cold.②In 40 cases of Chinese medicine group,21 cases were cured,3 cases were clear improved,15 cases were improved(the improvement rate was 97.5%,2 cases were ineffective. Total effective rate was 97.5%.③In regard of drug group among Taxol, Xeloda, L-OHP, L-OHP+Xeloda, showing no significant difference (P=0.137). In regard of the types of TCM syndrome, we found that it shows significant difference in efficacy between blood deficiency Type and blood heat Type, or between blood deficiency Type and blood heat Type.④In regard of the onset time of GradeⅠ-Ⅲshowing significant difference (F=4.646, P=0.016),GradeⅢ's onset time are much longer than GradeⅡand Grade I's. In regard of the onset time of drug groups showing no significant difference. In regard of the onset time of types of TCM syndrome showing significant difference, the Xuere Type needed more time to recovery.⑤In regard of treatment cycles shows significant difference, the longer course of treatment, the better result of treatment (P=0.000)⑥We followed up the patients for 2 months, didn't recrudescence. Conclusion:①The most common grades of peripheral nerve toxicity is "GradeⅠ", and the most common types of TCM syndrome are qi deficiency Type and blood deficiency Type. Most of patients have those symptoms of blood stasis, such as painful dark tongue,deep thready pulse, it may coincide the hypothesis that most patients has the physical condition of Qi-Blood deficiency and obstruction of meridian and collateral.②The TCM therapy in this study has definite therapeutic effect to peripheral nerve toxicity caused by anti-tumor chemotherapy drugs:It can improve patients'subjective symptoms significantly, reduce peripheral nerve toxicity. Compare with other types of TCM syndrome, qi deficiency Type and blood deficiency Type have more significant efficafy. Furthermore, The TCM therapy had no side effect. Altogether, it preliminary shows the advantages of Chinese medicine in reducing peripheral nerve toxicity caused by anti-tumor chemotherapy drugs.