Treatment of chemotherapy-related peripheral neuropathy with traditional Chinese medicine from the perspective of blood-arthralgia Zheng

  • Cao, Peng (Laboratory of Cellular and Molecular Biology, Jiangsu Province Institute of Traditional Chinese Medicine) ;
  • Yang, Jie (Laboratory of Cellular and Molecular Biology, Jiangsu Province Institute of Traditional Chinese Medicine) ;
  • Cai, Xueting (Laboratory of Cellular and Molecular Biology, Jiangsu Province Institute of Traditional Chinese Medicine) ;
  • Wang, Xiaoning (Laboratory of Cellular and Molecular Biology, Jiangsu Province Institute of Traditional Chinese Medicine) ;
  • Huo, Jiege (Laboratory of Cellular and Molecular Biology, Jiangsu Province Institute of Traditional Chinese Medicine)
  • Received : 2012.08.09
  • Accepted : 2012.11.05
  • Published : 2012.11.30


Traditional Chinese medicine classifies peripheral nerve impairment as paralysis and arthromyodynia, and considers that it is the result of defects of meridians and vessels, QI and blood, bones and muscles. Huangqi (Astragalus) Guizhi (Cassia Twig) Wuwu Tang, as a Qi invigorating formula, is usually used to improve peripheral nerve impairment. In recent years, some scholars have conducted research into Chemotherapy-induced peripheral neuropathy (CIPN) treatment with Huangqi Guizhi Wuwu Tang and certain values of this treatment approach have been identified. CIPN is a type of blood-arthralgia Zheng in traditional Chinese medicine theory. In this review, we will discuss the treatment of CIPN with Huangqi Guizhi Wuwu Tang according to blood-arthtalgia Zheng.


  1. Argyriou AA, Bruna J, Marmiroli P, Cavaletti G. Chemotherapy-induced peripheral neurotoxicity (CIPN): an update. Crit Rev Oncol Hematol. 2012;82:51-77.
  2. Beijers AJ, Jongen JL, Vreugdenhil G. Chemotherapy-induced neurotoxicity: the value of neuroprotective strategies. Neth J Med. 2012;70:18-25.
  3. Cavaletti G, Fabbrica D, Minoia C, Frattola L, Tredici G. Carboplatin toxic effects on the peripheral nervous system of the rat. Ann Oncol. 1998;9:443-447.
  4. Cavaletti G, Pezzoni G, Pisano C, Oggioni N, Sala F, Zoia C, Ferrarese C, Marmiroli P, Tredici G. Cisplatin-induced peripheral neurotoxicity in rats reduces the circulating levels of nerve growth factor. Neurosci Lett. 2002;322:103-106.
  5. Cersosimo RJ. Oxaliplatin-associated neuropathy: a review. Ann Pharmacother. 2005;39:128-135.
  6. Chaplan SR, Bach FW, Pogrel JW, Chung JM, Yaksh TL. Quantitative assessment of tactile allodynia in the rat paw. J Neurosci Methods. 1994;53:55-63.
  7. Cheng J, Wu G, Wu H. Clinical observation of gemcitabine and concurrent three-dimensional conformal radiotherapy (3D-CRT) in the treatment of locally advanced non-small cell lung cancer. Zhongguo Fei Ai Za Zhi. 2004;7:442-445.
  8. Grothey A, Nikcevich DA, Sloan JA, Kugler JW, Silberstein PT, Dentchev T, Wender DB, Novotny PJ, Chitaley U, Alberts SR, Loprinzi CL. Intravenous calcium and magnesium for oxaliplatin-induced sensory neurotoxicity in adjuvant colon cancer: NCCTG N04C7. J Clin Oncol. 2011;29:421-427.
  9. Hartmann JT, Lipp HP. Toxicity of platinum compounds. Expert Opin Pharmacother. 2003;4:889-901.
  10. Holmes J, Stanko J, Varchenko M, Ding H, Madden VJ, Bagnell CR, Wyrick SD, Chaney SG. Comparative neurotoxicity of oxaliplatin, cisplatin, and ormaplatin in a Wistar rat model. Toxicol Sci. 1998;46:342-351.
  11. Jamieson SM, Liu J, Hsu T, Baguley BC, McKeage MJ. Paclitaxel induces nucleolar enlargement in dorsal root ganglion neurons in vivo reducing oxaliplatin toxicity. Br J Cancer. 2003;88:1942-1947.
  12. Jamieson SM, Subramaniam J, Liu JJ, Jong NN, Ip V, Connor B, McKeage MJ. Oxaliplatin-induced loss of phosphorylated heavy neurofilament subunit neuronal immunoreactivity in rat DRG tissue. Mol Pain. 2009;18:66.
  13. Jordan P, Carmo-Fonseca M. Cisplatin inhibits synthesis of ribosomal RNA in vivo. Nucleic Acids Res. 1998;26:2831-2836.
  14. Li Y, Cui HJ, Huang JC, Wu XQ. Clinical study of Jiawei Huangqi Guizhi Wuwu Decoction in preventing and treating peripheral neuro-sensory toxicity caused by oxaliplatin. Chin J Integr Med. 2006;12:19-23.
  15. McKeage MJ, Hsu T, Screnci D, Haddad G, Baguley BC. Nucleolar damage correlates with neurotoxicity induced by different platinum drugs. Br J Cancer. 2001;85:1219-1225.
  16. Scuteri A, Galimberti A, Maggioni D, Ravasi M, Pasini S, Nicolini G, Bossi M, Miloso M, Cavaletti G, Tredici G. Role of MAPKs in platinum-induced neuronal apoptosis. Neurotoxicology. 2009;30:312-319.
  17. Stacchiotti A, Rezzani R, Rodella L, Ventura RG. Lysosomal changes in rat spinal ganglia neurons after prolonged treatment with cisplatin. Acta Anat (Basel). 1995;153:236-242.
  18. Takeshita M, Banno Y, Nakamura M, Otsuka M, Teramachi H, Tsuchiya T, Itoch Y. The Pivotal Role of Intracellular Calcium in Oxaliplatin-Induced Inhibition of Neurite Outgrowth but Not Cell Death in Differentiated PC12 Cells. Chem Res Toxicol. 2011;24:1845-1852.
  19. Tong Y, Hou H. Effects of Huangqi Guizhi Wuwu Tang on diabetic peripheral neuropathy. J Altern Complement Med. 2006;12:506-509.
  20. Velasco R, Bruna J. Chemotherapy-induced peripheral neuropathy: an unresolved issue. Neurologia. 2010;25:116-131.
  21. Wei SY, Zhang PX, Yang DM, Zhang HB, Jiang BG. [Traditional Chinese medicine and formulas of improving peripheral nerve regeneration]. Zhongguo Zhong Yao Za Zhi. 2008;33:2069-2072.
  22. Wilson JA, Garry EM, Anderson HA, Rosie R, Colvin LA, Mitchell R, Fleetwood-Walker SM. NMDA receptor antagonist treatment at the time of nerve injury prevents injury-induced changes in spinal NR1 and NR2B subunit expression and increases the sensitivity of residual pain behaviours to subsequently administered NMDA receptor antagonists. Pain. 2005;117:421-432.
  23. Zhou HM, Chen SQ, Sun BG, Yin LR, Ye XY, Chen ZX. A clinical research of Jiawei simiaosan oral administration combined with the external application of Sihuangshuimi in the treatment of acute gouty arthritis. Zhong Yao Cai. 2007;30:1196-1198.