摘要
多发性骨髓瘤(Multiple Myeloma,MM)是一种克隆浆细胞异常增殖的恶性疾病,在血液系统中是第二常见的恶性肿瘤,以老年患者多见,诊断中位年龄65岁,对于大多数患者来说具有不可治愈性。随着蛋白酶体抑制剂等药物的不断应用和诊疗水平的提高,周围神经病变(Peripheral Neuropathy,PN)的发生率也逐年增加。超过60%的患者在治疗过程中出现PN,打乱了患者的化疗周期,严重影响了疗效,降低了患者的生活质量。其临床表现与神经受损有着密切的关系,表现为感觉神经、运动神经及自主神经受损的症状或体征,患者常出现手指及足趾感觉迟钝、异常和过敏,如麻木、刺痛感等,引起PN的化疗药物包括硼替佐米、沙利度胺、长春新碱等,且发病机制各不相同。目前尚无有效治疗手段,以预防和对症治疗为主,西医主要通过调整药物剂量,改变给药方式,给予神经营养剂等对症治疗大量临床研究表明,中医药在治疗多发性骨髓瘤周围神经病变(Multiple Myeloma Peripheral Neuropathy,MMPN)方面具有优越性,中药汤剂口服、足浴、熏洗、针灸、穴位贴敷等都取得了较好的疗效。因此,对于MMPN发病机制及相关预防药物的研究成为目前研究的热点,希望能够达到更好的治疗效果。
Multiple myeloma(MM)is a malignant disease with abnormal proliferation of clonal plasma cells,and is the second most common malignant tumor in the blood system.It is most common in elderly patients with a median age of 65 years when diagnosed,and is incurable for most patients.With the continuous application of proteasome inhibitors and other drugs and the improvement of diagnosis and treatment level,the incidence of peripheral neuropathy(PN)is also increasing year by year,and more than 60%of patients have peripheral neuropathy during treatment,which disrupts the chemotherapy cycle of patients,seriously affects the efficacy and reduces the quality of life of patients.Its clinical manifestations are closely related to nerve damage,which show symptoms or signs of sensory nerve,motor nerve and autonomic nerve damage,patients often have finger and toe numbness,abnormalities and allergies,such as numbness,tingling,etc.The chemotherapeutic drugs that cause peripheral neuropathy include bortezomib,thalidomide,vincristine,etc.,and the pathogenesis is different.At present,there is no effective treatment,which mainly focuses on prevention and symptomatic treatment.Western medicine mainly adjusts drug dosage,changes the way of administration,and gives neurotrophic agents and other symptomatic treatments.With the development of traditional Chinese medicine,more and more TCM therapies have been applied in clinical practice.Traditional Chinese medicine(TCM)has advantages in the treatment of multiple myeloma peripheral neuropathy(MMPN).Oral administration of TCM decoction,foot bath,fumigation,acupuncture,acupoint application and so on have achieved good curative effect.Therefore,the research on the pathogenesis of MMPN and related preventive drugs has become a hot spot at present,hoping to achieve better therapeutic effects.
作者
朱佳宇
戚振伦
刘朝霞
ZHU Jiayu;QI Zhenlun;LIU Zhaoxia
出处
《中医临床研究》
2024年第21期130-134,共5页
Clinical Journal Of Chinese Medicine
