四联液防治鼻咽癌患者放射性口腔黏膜反应的效果及其机制

Effect of quadruple fluid aerosol inhalation on oral mucositis induced by radiotherapy in nasopharyngeal carcinoma and its mechanism

目的：探讨四联液防治鼻咽癌患者放疗所致口腔黏膜反应的效果及其机制。方法：将120例接受放射治疗的鼻咽癌患者随机均分为治疗组及对照组。对照组在整个放疗期间进行常规口腔护理;治疗组除常规口腔护理外,采用ZBC41001-85晶体管超声雾化器,自放疗开始每天雾化吸入四联液,每天2次,每次15～20min。检测两组放疗期间唾液分泌量变化,ELISA法检测唾液中表皮生长因子（epidermal growth factor,EGF）含量。结果：放疗至30Gy和60Gy时,两组疗效对比有统计学意义（P〈0.05）。对照组放疗至30Gy和60Gy时唾液中EGF含量较放疗前明显下降（P〈0.01）;治疗组放疗至30Gy时唾液中EGF含量较放疗前对比无统计学差异;放疗至60Gy时唾液中EGF含量较放疗前下降（P〈0.05）。结论：四联液可用于综合防治鼻咽癌患者放射性口腔黏膜反应,其作用机制与延缓唾液中EGF含量下降有关。

Objective To explore the effect of quadruple fluid aerosol inhalation on oral mucositis induced by radiotherapy in nasopharyngeal carcinoma （NPC） and its mechanism. Methods One hundred and twenty NPC patients were divided into a treatment group （n = 60 ） and a control group （ n = 60 ）. Radiation therapy was administered conventionally over 7 weeks with 2.0 Gy daily fractions for 5 days each week at the 70 Gy. Patients in the control group accepted oral care conventionally, and patients in the treatment group used quadruple fluids aerosol inhalation before the radiotherapy. The saliva volume was measured by a nurse twice a week and the concentration of epidemal growth factor （EGF） was examined by ELISA. Results The number of patients with mucositis in the treatment group was significantly fewer than that in the control group when the total doses were up to 30 Gy and creased when the treatment 60 Gy （ P 〈 0.05 ）. The concentration of total doses group was EGF in the control group significantly dewere up to 30 Gy and 60 Gy （P〈0.01）. The concentration of EGF in not significantly different compared with pre-radiotherapy when the total doseswere up to 30 Gy, but when total doses were up to 60 Gy, the concentration of EGF in the treatment group obviously decreased compared with that of pre-radiotherapy. Conclusion The quadruple fluid aerosol inhalation is effective to reduce oral mucositis resulted from radiotherapy in NPC patients, which is related to the delay of the EGF decrease in the saliva.