鼻咽癌放疗患者采用中药液含漱减轻口腔黏膜反应的效果观察

Effect of Chinese medicine liquid to gargle on relieving the oral mucosa reaction in nasopharyngeal carcinoma patients with radiotherapy

目的：探讨鼻咽癌放射治疗患者采用中药液含漱对口腔黏膜反应的效果。方法将100例首程放射治疗鼻咽癌患者按照随机数字表法随机分为对照组和观察组各50例。对照组采用消炎漱口液含漱，观察组采用自制中药液含漱，将黄柏25 g，黄芩25 g，蒲公英25 g，薄荷5 g混合清水洗净，置水沙煲内加水1000 ml文火煮沸后再用慢火煎煮30 min，纱布过滤，待冷却置于500 ml瓶中每日三餐前后、放疗前、睡前分次含漱。治疗期间和结束后采用WHO口腔黏膜放射性损伤分级标准进行评价，对患者口咽部进行微生物学监测。结果放射治疗第3周末、第7周末、结束后1周末，观察组口腔黏膜反应情况均轻于对照组，两组比较差异均有统计学意义（Z值分别为37．645，22．880，10．874；P＜0．05）。放射治疗第7周末，观察组咽拭子细菌培养阳性率为16．0％（8/50），对照组为34．0％（17/50），差异有统计学意义（χ2＝4．320，P＜0．05）。结论中药液含漱可有效预防与减轻鼻咽癌放射治疗所致口腔黏膜反应，减少口腔感染。

Objective To explore the effect of Chinese medicine liquid to gargle on the oral mucosa reaction in nasopharyngeal carcinoma patients with radiotherapy .Methods One hundred nasopharyngeal carcinoma patients with radiotherapy were divided into the control group and the observation group according to the random number table , each with 50 cases.The control group received anti-inflammatory mouthwash to＆amp;nbsp;gargle, which included gentamicin 4 ml, dexamethasone 5 mg, lidocaine 20 ml, NS 250 ml, 5% sodium bicarbonate 250 ml.The observation group received the Chinese medicine liquid to gargle , which included AMUR CORK TREE BARK 25 g, SCUTELLARIA 25 g, DANDELION 25 g, MINT 5 g and were gargled before and after three meals a day, before radiotherapy, before bedtime.The microbiology in oropharyngeal was monitored during the treatment and after radiotherapy according to WHO oral mucosa radiation damage grading criteria . Results The oral mucosa reactions in the observation group were all lighter than those in the control group at the third weekend, the seventh weekend , and one week after radiotherapy , and the differences were statistically significant （Z=37.645,22.880,10.874, respectively;P 〈0.05）.The positive rate of throat swab bacterial culture was 16.0%（8/50） in the observation group , and was 34.0%（17/50） in the control group at the seventh weekend, and the difference was statistically significant （χ2 =4.320,P〈0.05）.Conclusions Chinese medicine liquid to gargle can effectively prevent and relieve the oral mucosa reaction induced by the radiotherapy for the treatment of nasopharyngeal carcinoma , and reduce oral infection .