Acupuncture combined with methylcobalamin for the treatment of chemotherapy-induced peripheral neuropathy in patients with multiple myeloma.
Acupuncture combined with methylcobalamin for the treatment of chemotherapy-induced peripheral neuropathy in patients with multiple myeloma.
复制标题
针刺联合甲钴胺治疗多发性骨髓瘤化疗所致周围神经病变
DOI：
10.1186/s12885-016-3037-z
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发表时间：
2017-01-09
期刊：
影响因子：
3.8
通讯作者：
Cai Z
中科院分区：
文献类型：
--
作者：
Han X;Wang L;Shi H;Zheng G;He J;Wu W;Shi J;Wei G;Zheng W;Sun J;Huang H;Cai Z
化疗引起的周围神经病变（CIPN）严重影响多发性骨髓瘤（MM）患者的生活质量和化疗的疗效。针灸在CIPN的治疗中具有潜在的作用，但目前还没有随机临床研究来分析针灸治疗CIPN的有效性，特别是在MM患者中。符合纳入标准的104名患者被随机分配到单独的甲钴胺治疗组（500 μg甲钴胺肌内注射，隔日一次，共20天; 10次注射），随后口服500 μg甲钴胺2个月，针刺联合甲钴胺（Met + Acu）组（甲钴胺同法，针刺3个周期）。104名患者中有98名完成了治疗和随访。每组49例。评估参数包括视觉模拟量表（VAS）疼痛评分、癌症治疗功能评估/妇科肿瘤组-神经毒性（Fact/GOG-Ntx）问卷评分和肌电图（EMG）神经传导速度（NCV）测定。结果治疗84天（3个周期）后，两组疼痛均明显减轻，针刺组疼痛减轻程度明显高于对照组（P< 0.01）。Met + Acu组患者的Fact/GOG-Ntx问卷评价的日常活动能力明显改善（P< 0.001）。Met + Acu组神经传导速度明显改善，而对照组神经传导速度无明显改善。结论本研究提示针刺联合甲钴胺治疗CIPN疗效优于单独应用甲钴胺。 ChiCTR-INR-16009079 ，注册日期2016年8月24日）。
BackgroundChemotherapy-induced peripheral neuropathy (CIPN) seriously affects the quality of life of patients with multiple myeloma (MM) as well as the response rate to chemotherapy. Acupuncture has a potential role in the treatment of CIPN, but at present there have been no randomized clinical research studies to analyze the effectiveness of acupuncture for the treatment of CIPN, particularly in MM patients.MethodsThe MM patients (104 individuals) who met the inclusion criteria were randomly assigned into a solely methylcobalamin therapy group (500 μg intramuscular methylcobalamin injections every other day for 20 days; ten injections) followed by 2 months of 500 μg oral methylcobalamin administration, three times per day) and an acupuncture combined with methylcobalamin (Met + Acu) group (methylcobalamin used the same way as above accompanied by three cycles of acupuncture). Of the patients, 98 out of 104 completed the treatment and follow-ups. There were 49 patients in each group. The evaluating parameters included the visual analogue scale (VAS) pain score, Functional Assessment of Cancer Therapy/Gynecologic Oncology Group-Neurotoxicity (Fact/GOG-Ntx) questionnaire scores, and electromyographic (EMG) nerve conduction velocity (NCV) determinations. We evaluated the changes of the parameters in each group before and after the therapies and made a comparison between the two groups.ResultsAfter 84 days (three cycles) of therapy, the pain was significantly alleviated in both groups, with a significantly higher decrease in the acupuncture treated group (P< 0.01). The patients’ daily activity evaluated by Fact/GOG-Ntx questionnaires significantly improved in the Met + Acu group (P< 0.001). The NCV in the Met + Acu group improved significantly while amelioration in the control group was not observed.ConclusionsThe present study suggests that acupuncture combined with methylcobalamin in the treatment of CIPN showed a better outcome than methylcobalamin administration alone.Trial registrationChina Clinical Trials Register (registration no. ChiCTR-INR-16009079 , registration date August 24, 2016).