Clinical Study On Treatment Of Peripheral Neurotoxicity Induced By Chemotherapy By Wenjing Tongluo Method

This dissertation is composed of two parts:the review articles and a clinical research.There are two review articles. The first one reviewed the progress in the recognition and prevention of chemotherapy-induced peripheral neuropathy, including common chemotherapy drugs causing peripheral neuropathy, pathogenesis, diagnosis, classification standard, as well as Traditional Chinese and Western treatments of chemotherapy-induced peripheral neuropathy. CIPN is a common side effect of chemotherapy, the clinical manifestations include peripheral nerve paresthesia or missing, and even dysfunction. CIPN reduced patient tolerance to chemotherapy, often resulting in dose reduction or disabled, and seriously affect the quality of life of patients. Modern medicine through basic and clinical research confirmed that glutathione, mixture of calcium and magnesium, vitamins and other drugs can be used for prevention and treatment of peripheral neurotoxicity, but not everyone agree because the effect is not ideal. Chinese medicine also shows certain advantages, due to the lack of large sample evidence based medicine efficacy, it need further practice and exploration. The second one reviewed Chinese external medicine treatment of tumors in clinical researches conducted a preliminary summary from the perspective of pharmacy, including traditional dosage form of Chinese external medicine treatment of tumors, commonly used dosage form and problems and prospects. Chinese medicine play the role of local or systemic treatment of human through different forms as a carrier. It is one of the distinctive Chinese medicine treatment. It gene rats a lot of new dosage forms, also achieved a certain effect with the application of advanced technology. Although there are some shortcomings, it will have innovative and broader development prospects combining with the progress of mod ern p harmacy.The second part is a clinical study.Objective:To investigate the effect and safety of the external use of Wenjing Tongluo treatment in CIPN.Methods:Using prospective and self-eontrolled research methods, collect 30 patients with peripheral neurotoxicity, which were caused by chemotherapy drugs. All the patients washed and soaked the diseased regions by Tongluo San treatment warmly, 20 minutes every time, twice daily,7 days as a cycle,2 cycles totally. Then formulate a Standard of peripheral nerve toxicity according to NCI, contrast the exchanges of peripheral nerve toxicity before and after treatment period, the neurotoxicity grade change after 2 months and the onset time, neurotoxic symptoms and safety index, for the sake of evaluating the efficacy and safety of Chinese medicine.Results:The observed results above use the actual value of the index as a parameter, using SPSS 20.0 statistical software for data processing, statistics.Efficacy index Results:(1) 30 patients,11 males and 19 females, with a medi-an age of 61.5 years (33-77), mainly to middle-aged; Predominantly colorectal cancer (14/30), the main chemotherapy drug:oxaliplatin(17/30), the common grades of peripheral nerve toxieity are grade Ⅰ、Ⅱ (27/30). (2) 14 patients were cured,1 cases were cured,14 cases effective, the total effective rate was 96. 67%. By paired t-test, neurotoxicity variability has a significant difference befor e and after treatment. (3) Ⅰ grade onset time was 5.1±3.3 days, II grade onset time was 7.2±1.9 days, Ⅲ grade onset time was 10.3±1.5 days. (4) Almost everyone showed four limbs numbness, sensory disturbances, and secondary sy mptoms showed more qi deficiency. (5) It showed no adverse reactions during treatment and 2 months of follow-up.Conclution:(1) Tumor and age are related, the elderly take a great risk of cancer. (2) Oxaliplatin is widely used in the treatment of colorectal cancer, is also one of the main peripheral nerve toxicity of chemotherapy drugs. (3) The common grades of peripheral nerve toxieity are grade Ⅰ、Ⅱ; Most of patients showed Qi Deficiency, showing the pathogenesis of qi deficiency and blood stasis, cold contact resistance. (4) The lighter the neurotoxicity grad, the more easily neurotoxic symptoms improved. (5) Wenjingtongluo treatment can reduce the peripheral neurotoxicity grade, improve the symptoms significantly, have good short and long term effect as well as good security. It has certain advantages in CIPN treatment, and it need increase the sample size, to carry out randomized, controlled, double-blind trial, combining with objective outcome measures in the future.