EP630 - Prevention of HFS after chemotherapy with XELOX regimen for colorectal cancer by improving local microcirculation with Huangqi Guizhi Wuwu Decoction

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Purpose/Background: To explore the clinical efficacy of Huangqi Guizhi Wuwu Decoction in preventing HFS after postoperative chemotherapy with XELOX regimen for colorectal cancer, and the mechanism of preventing HFS through local microcirculation.

Methods/Interventions: Sixty-three patients with postoperative XELOX chemotherapy for colorectal cancer admitted to the Second Hospital of intervention of Jiangsu Province from June 2022 to December 2023 were selected in the clinical trial and divided into 33 cases in the control group (XELOX chemotherapy regimen) and 30 cases in the observation group (Huangqi Guizhi Wuwu Decoction on the basis of XELOX chemotherapy regimen). The incidence of HFS, HFS grade, symptom score, pain score, bone marrow suppression, gastrointestinal reaction, liver and kidney function and other adverse reactions were compared between the two groups. In order to further verify the mechanism of action of Huangqi Guizhi Wuwu Decoction, animal experiments were conducted on this basis. Thirty clean-grade ICR female mice were selected and divided into intervention group, blank group and model group. The model group was treated with mouse XELOX chemotherapy protocol, and the intervention group was gavaged with Huangqi Guizhi Wuwu Decoction based on the model group. The incidence of HFS, foot perfusion, cold pain, hot pain and mechanical pain threshold were compared among the three groups.

Results/Outcomes: In clinical trials, compared with the control group, the incidence of HFS in the traditional Chinese medicine group was significantly reduced (χ 2=8.018, P< 0.01), the severity of HFS was reduced (χ 2=0.063, p< 0.05), and the symptom score and pain score were significantly reduced (P < 0.01). In the animal experiment, compared with the control group, the incidence rate of HFS in mice in the Chinese medicine group was reduced, with P< 0.05 on the 9th and 12th days. Perform repeated measures ANOVA on cold pain, hot pain, mechanical pain threshold, and average perfusion volume. The change in cold pain threshold of the model group is related to the intervention time and shows a downward trend (P < 0.05); Inter group effect analysis showed that the traditional Chinese medicine group decreased more rapidly than the model group and the blank group (F-group=3.661, P< 0.05). Analysis of variance was conducted on the cold pain thresholds of the three groups at each time point, and it was found that on the 9th, 15th, and 18th day after medication, the model group was lower than the blank group and the traditional Chinese medicine group, while the traditional Chinese medicine group was higher than the blank group (P < 0.05); on the 3rd, 6th, 9th, and 12th day after intervention, compared with the blank group and the traditional Chinese medicine group, the mechanical pain threshold of the model group decreased. Compared with the blank group, the mechanical pain threshold of the traditional Chinese medicine group decreased (P < 0.05); Compared with the model group, the average perfusion volume of the traditional Chinese medicine group significantly increased on days 6 and 9 (P < 0.01).

Conclusion/Discussion: Huangqi Guizhi Wuwu Decoctionwas able to prevent the onset of HFS and reduce the severity of its onset. It can prevent HFS in mice after XELOX chemotherapy by improving local microcirculation.