Prospective And Open Clinical Research On Acupuncture Treatment Of Hand-foot Syndrome

[BACKGROUD]Hand foot syndrome(HFS)is a common skin toxic damage caused by some systemic chemotherapy drugs.Clinical studies have reported that the occurrence of HFS is related to a variety of chemotherapy drugs,such as capecitabine,fluorouracil,oxaliplatin,paclitaxel,liposome adriamycin and so on.The incidence of HFS caused by chemotherapy drugs is 48%?62%reported at home and abroad.Although HFS does not threaten the life of patients,it will affect the quality of life of patients,and make patients suffer more physical and mental pain.In serious cases,it may lead to capecitabine drug reduction or even treatment interruption,and affect the further progress of anti-tumor treatment.There is no standard prevention and treatment plan for HFS.At present,the main intervention measures for HFS are patient education,pyridoxine,COX-2 inhibitor,cortisol,urea preparation and chemotherapy drug reduction or discontinuation.However,due to the limited efficacy of drugs to improve HFS and the existence of more adverse reactions,there is no very effective method for clinical treatment of HFS.Therefore,it is of great clinical significance in the prevention and treatment of HFSTraditional Chinese medicine plays an important role in the comprehensive treatment of tumor,especially in reducing various side effects and improving the quality of life of patients.Therefore,it is worth further research and exploration to find the treatment method of HFS in the excellent treasure house of Chinese medicine.The etiology and pathogenesis of HFS in traditional Chinese medicine are mostly based on the weakness of Qi and blood and the obstruction of pathogenic toxin.The traditional Chinese medicine treatment of HFS is mainly to invigorate the middle part of the body,to invigorate the Qi and blood,and to detoxify and dredge the collaterals.Acupuncture,which harmonizes Yin and Yang by pure physical therapy,has the functions of connecting internal organs,communicating internal and external,moving Qi and blood,nourishing the whole body,resisting external evils and protecting the body,and has a great prospect in the prevention and treatment of HPS.According to the basic principles of "meridians pass,acupoints are located,and points are located,and points are treated",the whole and the part are combined to replenish the vitality as a whole,activate the blood and remove blood stasis in the part,conduct stagnation and unblock the collaterals,so as to release blood stasis and toxin.The main points are KI 3?CV 4?SP 6?ST 36?ST 40?LI 4?LI 11?and Ashi.In this study,prospective and open clinical trials were used to explore the clinical efficacy and safety of acupuncture in the treatment of HFS,which provides reference for further in-depth exploration of the better treatment of HFS by traditional Chinese medicine[OBJECTIVE]1.To explore the clinical effect of acupuncture on HFS.2.Preliminary evaluation of the safety of acupuncture in the treatment of HFS[METHODS]The prospective and open clinical trial method was used in this study.24 patients to be enrolled in the study group were given education+acupoint(bilateral)acupuncture three times a week(Monday,Wednesday,Friday);HFS grade,symptom score,skindex-16 related index in Chinese version,Karnofsky score,European cancer treatment and research organization quality of life questionnaire(European Organization for research and Treatment quality of life questionnaires-cancer 30,EORTC QLQ-C30)scores in Chinese version,common symptoms of tumor and related indexes of Anderson symptom inventory traditional Chinese medicine(mdasi-tcm);safety indexes mainly include adverse reactions.Finally,the clinical efficacy and safety of acupuncture in the treatment of HFS were evaluated and statistically analyzed[RESULTS]1.General data:a total of 24 subjects were included,4 were lost,and 20 were included in the analysis.2.Changes of HFS classification before and after treatment:in 20 patients,2 patients had complete remission of HFS clinical symptoms,12 patients had decreased HFS classification,6 patients maintained stable state,the total effective rate was 70%(14/20).After treatment,the HFS classification decreased compared with before treatment,the difference was statistically significant(P<0.05).3.Skindex-16 score changes before and after treatment:the total score of skindex-16 after treatment was lower than that before treatment,the difference was statistically significant(P<0.05)4.Before and after treatment,the scores of common symptoms of HFS were significantly improved in numbness,acupuncture,dullness,burning,pain,erythema,desquamation,pigmentation and swelling(P<0.05).5.Changes of KPS score before and after treatment:KPS score after treatment was significantly improved compared with that before treatment,and the difference was statistically significant(P<0.05).6.The score changes of EORTC QLQ-C30 before and after treatment:after treatment,the scores of physical function,role function,emotional function,social function,fatigue,pain,anorexia,overall quality of life after treatment were significantly improved compared with before treatment,the difference was statistically significant(P<0.05).There was no significant difference in cognitive function,nausea and vomiting,shortness of breath,insomnia,constipation,diarrhea and economic difficulties between before and after treatment(P>0.05).7.The changes of mdasi-tcm scores before and after treatment:pain,sadness,pain and numbness,general activity,mood,work,fatigue,nausea,restlessness of sleep,upset,worst appetite,drowsiness,sweating,fear of cold,relationship with others,walking,fun of life were significantly improved after treatment compared with before treatment,the difference was statistically significant(P<0.05).There was no significant difference between the two groups(P>0.05).8.During the course of the study,there were 6 patients with bleeding after starting the needle,and the symptoms disappeared after the cotton swab pressed the pinhole,among which 1 patient had mild hematoma,and then recovered automatically.No serious adverse events were observed in the study.[CONCLUSION]Acupuncture may improve the symptoms of HFS,improve the quality of life,and have better safety.In view of the low level of evidence-based medicine and small sample size,more large sample and high-quality clinical research is needed to clarify the clinical effect of acupuncture on HFS.