“补肾活血”法预防硼替佐米治疗多发性骨髓瘤致周围神经病变的疗效观察

目的 通过观察多发性骨髓瘤(multiple myeloma,MM)患者应用硼替佐米后周围神经病变的发生率,探讨“补肾活血”法中药复方预防硼替佐米引起的周围神经病变的疗效。 方法 筛选2015年6月—2017年12月温州医科大学附属第六医院初治型多发性骨髓瘤患者40例为治疗组,采用硼替佐米为基础的化疗,并加用“补肾活血法”中药复方;以同期单纯化疗的42例MM患者为对照组。治疗6个周期,观察2组周围神经病变发生率,同时观察2组患者总体疗效。 结果 ①经治疗6个周期后,治疗组发生1~2级PN 9例,占22.5%,明显低于对照组的42.8%。同时,治疗组40例患者PN总发生率为27.5%;对照组42例患者,PN发生率为57.1%,2组比较差异有统计学意义(P=0.007)。②治疗6个周期后,治疗组40例患者达CR 6例,VGPR 20例,PR 10例,总有效率为90.0%,对照组总有效率为69.0%,2组总有效率比较差异有统计学意义(P=0.019)。 结论 “补肾活血”法中药复方可减少硼替佐米引起的周围神经病变发生率,同时显著提高硼替佐米治疗多发性骨髓瘤的疗效。 

Clinical observation on "Bushen Huoxue Method" in the prevention of peripheral neuropathy induced by bortezomib for multiple myeloma patient

Objective To observe the different incidence of peripheral neuropathy(PN) after bortezomib treatment of patients with multiple myeloma(MM), and to investigate the efficacy of traditional Chinese medicine compound for "Bushen Huoxue Method" in preventing PN caused by bortezomib. Methods A total of 40 patients with primary MM in our hospital from June 2015 to December 2017 were screened as treatment group. Bortezomib-based chemotherapy was used, and the Chinese medicine compound of "Bushen Huoxue Method" was added. At the same time, 42 patients with simple chemotherapy were observed as control group. After 6 cycles of treatment, the incidence of peripheral neuropathy and the overall efficacy were observed. Results ①After 6 cycles of treatment, 9 cases(22.5%) of grade 1-2 PN occurred in the treatment group, significantly lower than 42.8% in the control group. At the same time, the total incidence of PN was 27.5% in the treatment group and 57.1% in the control group, with statistically significant difference(P=0.007). ②After 6 cycles of treatment, there were 6 CR cases, 20 VGPR cases and 0 PR cases in the treatment group. The total effective rate of the treatment group and the control group were 90% and 69%, respectively, with statistically significant difference(P=0.019). Conclusion The traditional Chinese medicine compound for "Bushen Huoxue Method" can significantly reduce the incidence of PN caused by bortezomib and improve the efficacy of bortezomib in the treatment of MM.