【摘要】 目的 探讨针刺疗法治疗多发性骨髓瘤周围神经病变(MMPN)患者的效果及对血清炎症因子表达水平的影响。方法 选择新乡医学院第一附属医院血液内科收治的98例MMPN患者作为研究对象，按照随机数字表法分为对照组和针刺组，每组49例。对照组接受基础治疗和注射用腺苷钴胺1 mg肌内注射，每日1次，针刺组在对照组治疗的基础上接受针刺治疗，每日1次，每次20 min。MMPN患者神经病变的严重程度采用密歇根神经病变筛查表(MNSI)进行评估，周围神经病变分级采用NCI-CTC AE 4.0版本评估，评估并比较两组正中神经、腓总神经的感觉神经传导速度(SCV)和运动神经传导速度(MCV)及血清中白细胞介素-6(IL-6)、白细胞介素-10(IL-10)、肿瘤坏死因子-α(TNF-α)表达水平。比较两组治疗期间不良反应发生率。结果 与对照组相比，治疗后针刺组调查问卷得分和足部检查得分降低(P<0.001)。治疗后，对照组神经病变分级1级23例，2级26例，针刺组神经病变分级1级31例，2级18例(χ~2=5.014,P=0.025)。治疗后与对照组相比，针刺组神经传导速度升高，血清中IL-6、IL-10、TNF-α表达水平降低(P<0.001)。对照组治疗期间未发生不良反应，针刺组治疗期间2例发生局部皮肤瘀点瘀斑，两组不良反应发生率差异无统计学意义(χ~2=2.042,P=0.153)。结论 针刺疗法对MMPN有良好的治疗效果，能减轻周围神经病变程度，在机制上可能与降低血清中炎症因子的表达有关。更多还原

【Abstract】 Objective To investigate the therapeutic efficacy of acupuncture in the treatment of multiple myeloma peripheral neuropathy(MMPN) and its influence on serum inflammatory factors levels. Methods A total of 98 patients with MMPN in the Department of Hematology of the First Affiliated Hospital of Xinxiang Medical University were enrolled and divided into control group and acupuncture group according to random number table method, with 49 cases in each group. The control group received basic treatment and intramuscular injection of 1 mg of adenosine cobalamin once a day, while the acupuncture group received acupuncture treatment once a day for 20 minutes on the basis of the control group’s treatment. The severity of neuropathy in patients with MMPN was evaluated using the Michigan neuropathy screening scale(MNSI), and the peripheral neuropathy grade was evaluated using NCI-CTC AE 4.0 version. The sensory conduction velocity(SCV) and motor conduction velocity(MCV) of median, common peroneal nerve and serum interleukin-6(IL-6), interleukin-10(IL-10) and tumor necrosis factor a(TNF-α) expression levels were evaluated and compared between the two groups. The incidence of adverse reactions between two groups during treatment were compared. Results Compared with the control group, the acupuncture group showed a decrease in questionnaire scores and foot examination scores after treatment(P<0.001). After treatment, there were 23 cases with grade 1 and 26 cases with grade 2 neuropathy in the control group, and 31 cases with grade 1 and 18 cases with grade 2 neuropathy in the acupuncture group(χ~2=5.014, P=0.025). After treatment, compared with the control group, the acupuncture group showed an increase in nerve conduction velocity and a decrease in the expression levels of IL-6, IL-10, and TNF-α in serum(P<0.001). There were no adverse reactions observed during the control group treatment, while 2 cases of local skin bruising and ecchymoses occurred during the acupuncture group treatment. There was no statistically difference in the incidence of adverse reactions between the two groups(χ~2=2.042, P=0.153). Conclusion Acupuncture therapy has a good therapeutic efficacy on MMPN and can improve the severity of peripheral neuropathy, which may be related to reducing the serum inflammatory factors expression levels.更多还原