Topical Huzhang Sanhuang formula combined with standard nursing care is a safe and effective integrative nursing intervention that accelerates clinical recovery, alleviates local symptoms, and reduces the inflammatory burden in patients with chemotherapy-induced phlebitis compared to 50% magnesium sulfate wet dressing.
Key Findings
Results
Patients treated with topical HZSH formula showed significantly greater improvement in phlebitis severity compared to controls by Day 14.
Risk ratio for grade ≥ II phlebitis at Day 14 was 0.42 (95% CI: 0.20–0.87; P = 0.012) in favor of the experimental group
94 hospitalized patients with CIP (grade I or higher) were randomly assigned 1:1 to experimental (n = 47) or control (n = 47) groups
Treatment duration was 14 days
Control group received 50% magnesium sulfate wet dressing plus standard nursing care
Results
The HZSH experimental group demonstrated significantly larger reductions in VAS pain scores compared to the control group.
Reduction in visual analog scale (VAS) pain scores was significantly greater in the experimental group (P < 0.01)
VAS pain score was a prespecified primary outcome measure
Both groups received standard nursing care as a background treatment
Results
The HZSH experimental group showed significantly greater reductions in inflammatory biomarkers hs-CRP and IL-6 compared to controls.
Reductions in high-sensitivity C-reactive protein (hs-CRP) were significantly greater in the experimental group (P < 0.01)
Reductions in interleukin-6 (IL-6) concentrations were significantly greater in the experimental group (P < 0.01)
Both hs-CRP and IL-6 were prespecified outcome measures reflecting systemic and local inflammatory burden
Results
Kaplan-Meier analysis demonstrated faster resolution of multiple local symptoms in the HZSH experimental group.
Kaplan-Meier survival analysis was used to compare symptom resolution times between groups
Faster resolution was observed across multiple local symptoms in the experimental group
Symptom resolution time was a prespecified outcome measure
Results
Treatment adherence was high in both groups and no serious adverse events or major safety concerns were observed.
Safety indicators were among the prespecified outcomes monitored throughout the 14-day intervention
No serious adverse events were reported in either the HZSH or magnesium sulfate group
High adherence was observed in both the experimental and control groups
What This Means
This research suggests that a traditional Chinese herbal topical formula called Huzhang Sanhuang (HZSH), when applied to the skin along with standard nursing care, is more effective than the commonly used 50% magnesium sulfate wet dressing for treating chemotherapy-induced phlebitis (CIP). CIP is inflammation of the veins that can occur when chemotherapy drugs are delivered through a peripheral IV line, causing pain, redness, and swelling that can interrupt cancer treatment and reduce patients' quality of life. In this randomized controlled trial of 94 hospitalized patients treated over 14 days, those receiving the HZSH formula were significantly less likely to have moderate-to-severe phlebitis by the end of treatment and experienced faster relief from local symptoms.
The study also found that patients using the HZSH formula had significantly greater reductions in pain (measured by a visual analog scale) and in blood markers of inflammation, specifically high-sensitivity C-reactive protein and interleukin-6. These inflammatory markers suggest that the herbal formula may work by reducing the underlying inflammatory response that drives phlebitis symptoms. Both treatments were well-tolerated, with high adherence and no serious adverse events reported in either group.
This research suggests that topical HZSH formula could be a safe and potentially superior alternative to magnesium sulfate wet dressings for managing chemotherapy-induced phlebitis in hospitalized cancer patients. Because CIP is a common complication that can disrupt chemotherapy schedules and worsen patient well-being, having additional effective, low-risk treatment options could be meaningful for oncology nursing care. Further research in larger and more diverse populations would help confirm and extend these findings.
Zheng X, Ke Y, Cheng X, Gao X, Tong J, Zhu S. (2026). Effectiveness of Topical Huzhang Sanhuang with Standard Nursing for Chemotherapy-Induced Phlebitis: Randomized Controlled Study.. Journal of visualized experiments : JoVE. https://doi.org/10.3791/71288