养阴生血合剂防治鼻咽癌患者放射性口腔黏膜损伤30例临床观察

Clinical Observation on Yangyin Shengxue Mixture in Prevention and Treatment of Radiation Injury of Oral Mucosa in Nasopharyngeal Carcinoma Patients:A Report of 30 Cases

目的观察养阴生血合剂防治鼻咽癌患者放射性口腔黏膜损伤的临床疗效。方法将60例根治性放疗鼻咽癌患者随机分为治疗组和对照组各30例,治疗组在放疗前3天开始至放疗结束后1周服用养阴生血合剂,对照组采用浓替硝唑含漱液常规口腔护理。观察两组患者口腔黏膜损伤出现时间,分别于治疗前后检测患者体重、血红蛋白及感染情况,并根据RTOG急性放射性口腔黏膜损伤分级标准和数字评估(NRS)评价患者口腔黏膜损伤及疼痛等级。结果放疗期间两组患者均出现不同程度的放射性口腔黏膜损伤,但治疗组出现黏膜损伤时间明显晚于对照组(P<0.05);且治疗组口腔黏膜Ⅲ、Ⅳ级损伤例数和中、重度疼痛例数均少于对照组(P<0.05);治疗组体重减轻、血红蛋白减少、白色念珠菌感染的发生率亦低于对照组(P<0.05)。结论养阴生血合剂预防用药可推迟放射性口腔黏膜炎的发生、降低其损伤程度并能缓解患者口腔疼痛。

Objective To observe the preventive and therapeutic effect of Yangyin Shengxue Mixture （Herbal decoction for nourishing yin and blood） on radiation-induced oral mucosal injury. Methods Sixty nasopharyngeal carcinoma patients were randomized into two groups： treatment group （30 cases） receiving Yangyin Shengxue Mixture three days before till one week after radiotherapy, and control group （30 patients） using conventional Tinidazole Gargle for prevention of oral-mueositis. Before and after treatment, the body weight, hemoglobin and state of infection of patients were examined. The time of occurrence of symptoms, degree of acute radiation mucositis and degree of pain were observed to evaluate the damage of oral mucosa according to RTOG standard for radiation injury of oral mucosa and Numeric Rating Scales （NRS）. Results There were different degrees of radiation mueositis in both groups during radiotherapy, but the time of occurrence in the treatment group was significantly later than that of the control group （P〈0. 05）. And the number of cases ofⅢ and IV degree of injury of oral mucosa and medium and severe pain in the treatment group were both less than those of the control group. The decrease of body weight and hemoglobin and incidence of candida albicans infection in the treatment group were also less than those of the control group （P〈0. 05）. Conclusion Yangyin Shengxue Mixutre can postpone the development of radiation injury of oral mueosa, decrease the degree of damage, and relieve pain.