吲哚美辛栓剂治疗放疗相关性口咽部黏膜炎所致疼痛的疗效观察

Therapeutic efficacy of indometacin in treatment of pain related to radiation-induced mucositis

目的评价吲哚美辛栓剂对放疗相关性口咽部黏膜炎所致疼痛的治疗效果。方法 58例经病理组织学或细胞学证实为头颈部恶性肿瘤,在接受放疗过程中出现急性放射性黏膜炎引起疼痛的患者,随机分为治疗组和对照组,治疗组在VAS(直观模拟标度尺评分法)≥4分给予吲哚美辛栓剂和常规治疗,对照组只给常规治疗。结果疼痛缓解有效率治疗组为89.7%,对照组为27.6%,差异有统计学意义;体重变化,治疗组体重稳定率在放疗中及放疗结束后分别为69.0%、37.9%,在对照组仅为34.5%、17.2%,差异有统计学意义;治疗组的不良反应主要为腹泻、肛门部不适,均为轻度反应,未见中重度不良反应。结论吲哚美辛栓剂可控制急性放射性黏膜炎所致疼痛,其作用强、不良反应轻,能够使患者放疗顺利完成,有利于提高放疗疗效,值得在临床上推广应用。

Objective To evaluate the efficacy of indometacin in treatment of pain syndrome related to radiation-induced mucositis.Methods Fifty-eight cases of head and neck malignancies with radio-therapeutic mucositis pain were randomly divided into two groups： one group were treated with both indometacin and normal therapy,the other group received normal therapy.Results By using the indometacin,the pain relief rate during the radiotherapy was 89.7%,which was 27.6% in control group.In the treatment group,the body weight stable ratio in radiation and after radiation are 69.0% and 37.9%,which was 34.5% and 17.2% in control group.The chief side effects were reduced.Conclusion Indometacin could relieve pain with radio-therapeutic mucositis pain in radiotherapy to head and neck malignancies treated and should be further evaluated prospectively in controlled clinical trials.