| ObjectiveA randomized controlled study was conducted to evaluate the oxaliplatin-induced peripheral neuropathy by using Current Perception Threshold,and to observe the clinical efficacy of Shuangjinlong externalwashing prescription in the prevention and treatment of oxaliplatin-induced peripheral neuropathy.It provides evidence-based medicine basis for the clinical popularization of Shuangjinlong external washing prescription in the prevention and treatment of oxaliplatin-induced peripheral neuropathy.MethodSixty patients with colorectal cancer who were classified as stasis toxin internal knot type and who were about to be treated with oxaliplatin regimen were randomly divided into control group(n=30)and treatment group(n=30).The treatment group began to soak the limbs with Shuangjinlong external washing prescription on the day of chemotherapy,once a day,20min each time.On the day of chemotherapy,the limbs of the control group were soaked in warm water with water temperature of 40℃,and the immersion method and time were the same as those of the treatment group.The incidence of neurotoxicity,Current Perception Threshold,TCM symptoms and KPS score were observed and recorded at three observation points before and after chemotherapy(cycle 3,6,9 after 2-week chemotherapy regimen or cycle 2,4 and 6 of 3-week chemotherapy regimen).SPSS23.0 was used to analyze the data.Results1.At the three observation points,there were 7 cases(25%),12 cases(42.9%)and 16 cases(57.1%)of peripheral neurotoxicity in the treatment group,respectively.In the control group,there were 9 cases(32.1%),13 cases(46.4%)and 23 cases(82.1%)respectively.The neurotoxicity above II grade was found in 0 cases,2 cases(7.1%)and 4 cases(14.3%)in the treatment group and 1 case(3.6%),5 cases(17.9%)and 11 cases(39.3%)in the control group,respectively.The incidence of peripheral neurotoxicity in the two groups increased with the cumulative dose of oxaliplatin.There was no significant difference between the two groups at observation point 1 and 2(P>0.05),but there was significant difference between the two groups at observation point 3(P<0.05).There was significant difference in neurotoxicity between the two groups in pairs(P<0.01).The total incidence of peripheral neurotoxicity and the incidence of neurotoxicity above Ⅱ in the treatment group were lower than those in the control group at the three observation points.2.There were 10 cases(35.7%),13 cases(46.4%)and 16 cases(57.1%)in the treatment group,13 cases(46.4%)and 16 cases(57.1%)in the treatment group,respectively,at the three observation points after chemotherapy.There were 13 cases(46.4%),15 cases(53.6%)and 24 cases(85.7%)in the control group.The abnormal rate of CPT grade also increased with the increase of cumulative dose of oxaliplatin,and the abnormal rate of CPT grade in the treatment group was lower than that in the control group at three observation points.There was no significant difference between the two groups at observation point 1 and 2(P>0.05),but there was significant difference between the two groups at observation point 3(P<0.05).The results of CPT grade comparison between groups and pairwise comparison in the group were roughly consistent with the occurrence of neurotoxicity.The number of cases with abnormal CPT grade at the three observation points was higher than that of peripheral neurotoxicity.At the first observation point,the CPT grade of the two groups was mainly 5-6.99(hypersensitivity),and at the second and third observation points,the number of patients with grade 7-12(hypoesthesia)gradually increased and became the main part.3.After chemotherapy,there were 17 cases,20 cases and 19 cases in the treatment group and 10 cases,12 cases and 10 cases in the control group,respectively,in the evaluation of TCM curative effect at the three observation points of the two groups,17 cases,20 cases and 19 cases in the treatment group and 10 cases,12 cases and 10 cases in the control group,respectively.The results showed that there was significant difference in the evaluation composition of TCM syndrome curative effect between the two groups at the three observation points(P<0.05).4.The KPS score of the patients at the third observation point was higher than that of the control group,and the decrease rate of KPS score was lower than that of the control group.There was significant difference between the two groups(P<0.05).5.In the course of observation,there were no renal function damage and abnormal ECG changes in both groups.Grade I liver function damage occurred in 1 patient in the treatment group and 2 patients in the control group,which was considered to be related to the accumulation of chemotherapeutic drugs.The incidence of myelosuppression in the two groups increased with the increase of chemotherapy times,and there was no significant difference in the incidence of myelosuppression between the two groups at the three observation points(P>0.05),which was considered as an adverse reaction of chemotherapeutic drugs.No skin pruritus,rash and other skin toxicity and other related side effects which were relating to the washing prescription were found in the treatment group.Conclusions1.Shuangjinlong external washing prescription can reduce the incidence of peripheral neurotoxicity caused by oxaliplatin in patients with colorectal cancer with internal knot of stasis toxin,may reduce the severity of neurotoxicity,and improve the TCM symptoms and physical condition of patients to a certain extent.2.Shuangjinlong external washing prescription has good safety,and no obvious toxic and side effects were found in the course of observation.3.The peripheral neurotoxicity of oxaliplatin patients showed hypersensitivity in the early stage and hypoesthesia or loss in the later stage.The Current Perception Threshold can reflect the changes of peripheral nerve function objectively and sensitively,and can be used as one of the objective evaluation indexes of oxaliplatin peripheral nerve. |
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