加味补阳还五汤治疗白蛋白紫杉醇所致周围神经病变的随机对照研究OA

Objective:To observe the clinical efficacy of modified Buyang Huanwu Decoction in the treatment of chemotherapy-induced peripheral neuropathy(CIPN)caused by albumin-bound paclitaxel(ABP)in patients with qi deficiency and blood stasis type.Methods:A randomized controlled clinical trial was adopted.A total of 80 patients with CIPN of qi deficiency and blood stasis type who were admitted to the Outpatient and Inpatient Departments of the Oncology Department,900th Hospital of the Joint Logistics Support Force from February 2024 to December 2024 were selected and randomly divided into the control group and the treatment group,with 40 cases in each group.The control group was intervened with Methylcobalamin Tablets,while the treatment group was treated with modified Buyang Huanwu Decoction on the basis of the control group.Both groups received treatment for 6 weeks.The changes in peripheral neurotoxicity grading,NRS pain score,and TCM syndrome scores were observed in the two groups before and after treatment.Results:In terms of neurotoxicity grading,both groups showed significant improvement in CIPN grading after treatment compared with before treatment(P<0.05).The total effective rate of sensory neuropathy in the treatment group was 76.3%,which was significantly higher than 48.7%in the control group(P<0.05).The total effective rate of motor neuropathy in the treatment group was 81.6%,which was significantly higher than 56.4%in the control group(P<0.05).In terms of NRS pain score,both groups showed a significant decrease after treatment compared with before treatment(P<0.05),but there was no statistically significant difference between the two groups(P>0.05).In terms of TCM syndrome scores,the total TCM syndrome scores of both groups decreased significantly after treatment compared with before treatment(P<0.05).In the treatment group,the scores of all individual syndromes(numbness of hands and feet,tingling of hands and feet,fatigue,lack of qi and lassitude in speech,poor appetite,dark complexion,and rough skin and nails)were significantly lower than those before treatment(P<0.05).In the control group,the scores of some individual syndromes(numbness of hands and feet,tingling of hands and feet,fatigue,lack of qi and lassitude in speech,poor appetite)were significantly lower than those before treatment(P<0.05),while there was no significant difference in dark complexion and rough skin and nails compared with before treatment(P>0.05).After treatment,the total TCM syndrome score and the scores of some individual syndromes(numbness of hands and feet,fatigue,lack of qi and lassitude in speech,poor appetite,dark complexion)in the treatment group were significantly lower than those in the control group(P<0.05),while there was no statistically significant difference in the scores of tingling of hands and feet and rough skin and nails between the two groups(P>0.05).In terms of TCM syndrome efficacy,the total effective rate of the treatment group was 78.9%,which was significantly higher than 48.7%in the control group(P<0.05).There was no statistically significant difference in the incidence of myelosuppression and liver and kidney dysfunction between the two groups before and after treatment(P>0.05).Conclusion:Modified Buyang Huanwu Decoction combined with Methylcobalamin has a significant efficacy in the treatment of ABP-induced CIPN with qi deficiency and blood stasis type.It can reduce CIPN grading and NRS pain score,improve clinical symptoms,and has a good safety profile.