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目的:观察黄芪注射液防治含奥沙利铂化疗方案所致神经毒性的效果。方法:2006年9月至2008年9月胃癌或大肠癌患者40例纳入研究。患者中男23例,女17例,年龄32～75岁,平均年龄60岁,随机分为试验组和对照组,每组20例。所有患者均接受含奥沙利铂化疗方案1个周期,包含奥沙利铂130 mg/m2,第1天,氟尿嘧啶0.5 g,第1～5天,亚叶酸钙0.2 g,第1～5天;试验组加用黄芪注射液30 ml,第1～7天。观察外周神经毒性反应的表现,并测定神经生长因子(NGF)水平。结果:对照组中,发生0级毒性2例,Ⅰ级毒性10例,Ⅱ级毒性6例,Ⅲ级毒性2例;试验组中0级毒性14例,Ⅰ级毒性6例。试验组与对照组神经毒性发生率分别为30%和90%,2组比较差异有统计学意义(P<0.01)。试验组、对照组化疗前NGF值分别为:(167±10)和(204±19)ng/ml,化疗后第2天NGF的值分别为(152±8)和(133±12)ng/ml,对照组化疗后第2天与化疗前比较,NGF值下降明显,2组差异有统计学意义(P<0.01)。结论:黄芪注射液防治含奥沙利铂化疗方案所致神经毒性有一定效果。
Objective: To observe the effect of astragalus injection on neurotoxicity induced by oxaliplatin-containing chemotherapy. Methods: From September 2006 to September 2008, 40 patients with gastric or colorectal cancer were included in the study. There were 23 males and 17 females, aged from 32 to 75 years, with an average age of 60 years. They were randomly divided into experimental group and control group, with 20 cases in each group. All patients received one cycle of oxaliplatin-containing chemotherapy regimen, including oxaliplatin 130 mg / m2, day 1, fluorouracil 0.5 g, day 1 to day 5, leucovorin 0.2 g, days 1 to 5 ; Experimental group plus astragalus injection 30 ml, the first 7 days. The appearance of peripheral neurotoxicity was observed and the level of nerve growth factor (NGF) was measured. Results: In the control group, Grade 0 toxicity occurred in 2 cases, Grade I toxicity in 10 cases, Grade Ⅱ toxicity in 6 cases and Grade Ⅲ toxicity in 2 cases. Grade 0 toxicity was found in 14 cases and Grade Ⅰ toxicity in 6 cases. The incidence of neurotoxicity in test group and control group was 30% and 90%, respectively. There was significant difference between the two groups (P <0.01). The values of NGF in experimental group and control group before chemotherapy were (167 ± 10) and (204 ± 19) ng / ml, respectively. The values of NGF on the second day after chemotherapy were 152 ± 8 and 133 ± 12 ng / ml in the control group. The NGF value decreased significantly on the 2nd day after chemotherapy in the control group compared with that before chemotherapy. The difference between the two groups was statistically significant (P <0.01). Conclusion: Astragalus injection containing oxaliplatin chemotherapy induced neurotoxicity have some effect.