人工唾液和中药防治放射性口干的疗效观察

The Effect of Artificial Saliva and Chinese Traditional Medicine on Prevention and Treatment of Radioactive Xerostomia

目的:观察人工唾液及中药防治放射性口干的临床疗效。方法:62例首程放疗的鼻咽癌采用信封法分两组,研究组32例,于放疗开始时每天含漱人工唾液及口服中药柴芍地黄汤至放疗后1年,对照组30例,不使用人工唾液及中药。分别于放疗前、放疗结束时及放疗后1年,采用放射性核素动态显像定量检测两组患者的唾液腺(腮腺和下颌下腺)摄锝率(UR)和泌锝率(ER),同时观察口干、咀嚼、吞咽等情况,并进行生活质量评价。结果:放疗前及放疗结束时,两组患者的唾液腺UR和ER无显著差别。放疗后1年,研究组的UR、ER分别为1.85±0.50和2.95±0.61,而对照组的UR、ER分别为1.22±0.44和1.62±0.47,前者高于后者,差异有统计学意义(P<0.05);放疗后半年,中、重度口干发生率在研究组和对照组分别为46.9%(15/32)和73.3%(22/30),放疗后1年中、重度口干发生率分别为37.5%(12/32)和66.7%(20/30),研究组低于对照组,P<0.05。结论:使用人工唾液和中药能减轻放射性口干,促进唾液腺功能的恢复,提高患者的生活质量。

Objective： To study the effect of artificial saliva and Chinese traditional medicine in patients with xerostomia resulting from radiotherapy. Methods： A total of 62 patients with nasopharyngeal carcinoma receiving primary radiotherapy were divided into 2 groups, i.e. the treatment group （n= 32） receiving artificial saliva and Chinese traditional medicine every day from the beginning of radiotherapy to 1 year after withdrawal of radiotherapy, and the control group （n=30） without receiving the treatment. Uptake rate CUR） and excretion rate （ER） of parotid and submandibular gland were examed with quantitative ^99TcO4^- scintiphotography before radiotherapy, after withdrawal of radiotherapy and 1 year after termination of the radiotherapy. Oral dryness and ability of chewing, swallowing and speaking were observed during the study. Results： There was no significant difference between the UR and ER of the patients＇ parotid and submandibular gland in treatment group and control group, before and after radiotherapy. The UR and ER was 1.85±0.50 and 2.95±0.61, respectively in the treatment group and was 1.32±0.44 and 1.62±0.47, respectively in the control group. One year after radiotherapy, the UR and ER in the treatment group were higher than those in the control group （P〈0.05）. Six months after radiotherapy, the rate of moderate and severe xerostomia was 46.9% （15/32） in treatment group, and 73.3% （22/30） in control group （P〈0.05）. One year after radiotherapy, the rate of moderate and severe xerostomia was 37.5% （12/32） in the treatment group and was 66.7% （20/30）in the control group（P〈0.05）. Conclusions： Artificial saliva and Chinese traditional medicine are effective for radiation xerostomia, and they can improve the quality of life for patients with salivary gland dysfunction.