| This thesis consist of two parts:the literature review and the clinical observation.The first part is a literature review.It is made up of two parts::one introduced the Mesylate apartinib mesylate and its related hand and foot skin reactions.Apatinib mesylate is a novel small molecule tyrosine kinase inhibitor that acts highly selectively on vascular endothelial growth factor receptor 2 and potently inhibits tumor angiogenesis,thereby exerting an anti-tumor effect.One of the common side effects of apatinib is the skin reaction of the hands and feet.The pathogenesis of hand and foot skin reactions is related to the pharmacological effects of apatinib.Clinical manifestations of skin erythema,swelling,pain,hyperkeratosis,accompanied by paresthesia.Conclusion:The occurrence of apatinib-related hand-foot skin reaction is related to the inhibition of vascular endothelial growth factor and the decrease of capillary repair ability.It can be prevented by life care,and the severity of hand-foot skin reaction can be alleviated by adjusting the dosage of apatinib.Summary 2 The understanding of Chinese medicine on the skin reactions of hand and foot related to apatinib.According to the clinical manifestations,pathogenesis and pathogenesis of HFSR,combined with TCM classics,HFSR is considered to be the category of "sickness"in Chinese medicine.Through the study of sputum,the etiology and pathogenesis of HFSR,syndrome differentiation,internal treatment and external treatment are summarized.The Chinese medicine treatment of HFSR was summarized and analyzed,which provided a theoretical basis for further research on the treatment of HFSR.The second part is the clinical studythe clinical study 1:The Clinical study of the prevention of apatinib-related HFSR withshouzuping2.To observe the topical Chinese medicine "shouzuping2"to prevent and delay the anti-angiogenesis inhibitor apatinib related hand-foot skin reaction(HFSR)The efficacy and evaluation of drug safety,patient satisfaction.METHODS:Patients with a clear pathological diagnosis and taking apatinib 500 mg or above were enrolled in the study.The topical self-made traditional Chinese medicine "shouzuping 2" was selected to observe the time and extent of apatinib-related HFSR or 56 days and blood.Safety indicators such as routine,liver and kidney function.RESULTS:17 patients were enrolled and 2 patients were absent.84.6%of patients had no HFSR,and the HFSR was 15.4%,which was lower than the 27.35%reported in the literature.The two patients with HFSR appeared later and to a lesser extent.Conclusion:Hand-foot Ping 2 can effectively prevent and delay the emergence of HFSR.the clinical study 2:The Clinical studyof treatment of apatinib-related HFSR with shouzuping 1.To observe the efficacy of the traditional Chinese medicine "shouzuping 1"in treating the angiogenesis inhibitor apatinib related to hand-foot skin reaction(HFSR).And evaluate the safety of the drug,patient satisfaction.METHODS:Patients with HFSR who had a clear pathological diagnosis and had HFSR after application of apatinib were enrolled.The self-made traditional Chinese medicine“shouzuping 1”was used to observe the changes of HFSR classification and safety indicators such as blood routine and liver and kidney function before and after treatment.RESULTS:Twenty-seven patients were enrolled,21patients completed clinical observation,and 6 patients fell off.The effective rate was 76.2%(16/21).There were no serious drug-related adverse events during clinical observation,and the safety was good.Conclusion:"shouzuping 1"is effective in the treatment of apaprin-related HFSR.The treatment of apaprini-related HFSR is mainly to improve pain.The pain relief rate is 76.2%.At the same time,it promotes healing,induration and softening effect,HFSR with Infected patients have good infection control effect,and the effective rate is 100%.Can effectively improve the quality of life of patients.There was no obvious adverse reaction,but more clinical trials were needed to confirm it. |
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