Clinical Study On Intervention Of Oxaliplatin Peripheral Neurotoxicity By Internal And External Combination Therapy Of Benefiting Temperature,Promoting Yang And Activating Blood Circulation

Objective:To provide more theoretical and clinical research basis for the prevention and treatment of oxaliplatin-induced peripheral neurotoxicity by traditional Chinese medicine through clinical observation of the efficacy of combined treatment of stomach cancer and colorectal cancer patients with the method of nourishing temperature,promoting Yang and activating blood circulation.Methods:All cases in this trial were patients hospitalized in the Oncology Department of Affiliated Hospital of Shandong University of Traditional Chinese Medicine from May 2019 to February 2020.All the 60 patients were diagnosed with stage Ⅱ-Ⅳ gastric or colorectal cancer,and they had to undergo adjuvant or palliative chemotherapy after surgery,and the chemotherapy regimen mainly consisted of oxaliplatin was chosen.The enrolled patients were randomly divided into test group and control group by envelope method.The intervention started on the first day of the first chemotherapy.The test group was treated with the method of tonifying temperature,Promoting Yang and activating blood circulation,and the control group was treated with the combination of mecobalamin tablets and vitamin B6 tablets.Set two observation points,the end of the second cycle of chemotherapy(the first observation point)and the end of the fourth cycle of chemotherapy(the second observation point),to observe various indicators and evaluate the clinical efficacy.Results:Patients who completed the trial:28 in the control group,29 in the experimental group,a total of 57.(1)At the first observation point,the incidence and severity of peripheral neurotoxicity in the experimental group were less than those in the control group,and the difference was not statistically significant.At the second observation point,the incidence and severity of peripheral neurotoxicity in both groups were higher than those at the first observation point,but the experimental group was lighter than the control group,and the difference was statistically significant.(2)At the first and second observation points,the total scores of TCM syndromes in the experimental group were less than those in the control group,and the difference was statistically significant;The scores of cold extremities,numbness of extremities,fatigue,clear and long urine,loose stool and skin nails in the experimental group were less than those in the control group,and the difference was statistically significant.(3)At the first observation point,the KPS score of the test group was greater than that of the control group,and the difference was not statistically significant.At the second observation point,the KPS score of the experimental group was greater than that of the control group,and the difference was statistically significant.(4)At the first and second observation points,the incidence of bone marrow toxicity in the experimental group was lower than that in the control group,and the difference was statistically significant;the occurrence of hepatotoxicity and nephrotoxicity was not statistically significant;the occurrence of bone marrow toxicity,hepatotoxicity and nephrotoxicity were mild abnormalities..Conclusion:Oxaliplatin-induced peripheral neurotoxicity in patients with gastric cancer and colorectal cancer treated with the method of tonifying temperature and activating blood circulation has a significant effect,which can significantly reduce the incidence and severity of peripheral neurotoxicity compared with the western medicine group,and the longer the medication time,the more obvious the effect;at the same time,it can also improve the symptoms of traditional Chinese medicine,improve the quality of life,reduce bone marrow suppression,and has a high safety,good clinicalBed application value.