针灸对多发性骨髓瘤患者化疗相关周围神经病变的干预效果

Intervention effect of acupuncture and moxibustionin treatment of chemotherapy-induced peripheral neuropathy in patients with multiple myeloma

  • 摘要:
      目的  探讨针灸对化疗相关周围神经病变(CIPN)的多发性骨髓瘤(MM)患者生活质量及预后的影响。
      方法  将符合入选标准的54例MM患者随机分为药物组28例和针灸组26例。采用肌电图(EMG)记录神经传导速度(NCV), 评估治疗效果。分别记录2组患者治疗前后运动神经传导速度(MNCV)、感觉神经传导速度(SNCV)及癌症治疗功能评价系统/妇科肿瘤组-神经毒性评价工具量表(FACT/GOG-Ntx)评分。
      结果  2组治疗后的正中神经和腓总神经MNCV与治疗前比较,差异有统计学意义(P < 0.05); 药物组治疗后腓浅神经SNCV与治疗前比较,差异有统计学意义(P < 0.05)。治疗后,针灸组FACT/GOG-Ntx量表评分下降,差异有统计学意义(P < 0.01); 药物组治疗后FACT/GOG-Ntx量表评分也有所下降,但差异无统计学意义(P>0.05); 2组治疗后FACT/GOG-Ntx量表评分比较,差异无统计学意义(P>0.05)。
      结论  针灸是多发性骨髓瘤CIPN的有效干预手段之一,可提高患者的生活质量。

     

    Abstract:
      Objective  To investigate the effect of acupuncture and moxibustion on quality of life and prognosis of multiple myeloma (MM) patients with chemotherapy-related peripheral neuropathy (CIPN).
      Methods  Fifty-four MM patients who met the inclusion criteria were randomly divided into drug group (n=28) and acupuncture and moxibustion group (n=26). Electromyography (EMG) was used to record nerve conduction velocity (NCV), and the therapeutic effect was evaluated. Motor nerve conduction velocity (MNCV), sensory nerve conduction velocity (SNCV) and Functional Assessment of Cancer Therapy/Gynecologic Oncology Group-Neurotoxicity (FACT/GOG-Ntx) scores were recorded before and after treatment in two groups.
      Results  MNCV of median nerve and common peroneal nerve after treatment of two groups showed a significant difference compared with that before treatment (P < 0.05). The SNCV of the superficial peroneal nerve in the drug group showed a significant difference compared with that before treatment (P < 0.05). After treatment, FACT/GOG-NTX score of the acupuncture and moxibustion group decreased (P < 0.01). The FACT/GOG-NTX score of the drug group also decreased after treatment, but no significant difference was found (P>0.05). There was no significant difference in FACT/GOG-NTX score between the two groups after treatment (P>0.05).
      Conclusion  Acupuncture and moxibustion is an effective therapy for treating chemotherapy-induced peripheral neuropathy and can improve patients′quality of life.

     

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