维生素C与康复新防治头颈部肿瘤放疗引起口腔黏膜损伤的临床研究

Vitamin C and Kangfuxin liquid alleviate radiation-induced oral mucosal injury in patients with neck and head cancer under radiotherapy

目的评价维生素C加康复新口服液治疗头颈部肿瘤放疗引起放射性口腔黏膜损伤的应用价值。方法选取32例头颈部肿瘤患者作为研究组。研究组在整个放疗期间进行常规口控护理及雾化吸入至放疗结束,并从放疗开始口服维生素C片1.0 g,每天3次,康复新10 mL,每天3次,直至放疗结束后30天。另选同期头颈部恶性肿瘤放疗患者32例作为对照组。对照组常规口腔护理及雾化吸入至放疗结束。监测两组放疗期间口腔黏膜反应及疼痛情况、口腔pH值和涎液分泌量的变化,记录患者口腔干燥、涎液改变与放疗剂量的关系。比较两组发生口腔黏膜反应程度及口腔干燥的程度。结果放疗剂量40 Gy、70 Gy及放疗结束30天研究组Ⅲ级口腔黏膜损伤程度明显少于对照组（P〈0.05）,且放疗结束后30天无Ⅳ级损伤;研究组Ⅲ～Ⅳ级口腔干燥症明显少于对照组（P〈0.05）;研究组涎液分泌量〉3 mL者及口腔pH值〉5.5～6.0者均多于对照组（P〈0.05）。结论维生素C加康复新口服液明显减轻头颈部肿瘤放疗引起的放射性口腔黏膜损伤。

Objective To evaluate the efficacy of vitamin C and Kangfuxin liquid in the alleviation of radiationinduced oral mucosal injury in patients with head and neck cancer under radiotherapy. Methods Sixty-four patients with neck and head cancer undergoing radiotherapy were enrolled in the study. All patients received conventional oral care and inhalation; patients in experimental group（ n = 32） had additional oral administration of vitamin C tablets 1. 0 g t. i. d and Kangfuxin liquid 10 mL t. i. d from the start of radiotherapy till 30 d after the therapy,while patients in control group（ n =32） had routine management only. The prevalence of oral mucositis,oral pH,saliva secretion,pain,dry mouth and radiation dose were monitored. Results The incidents of Ⅲ degree oral mucosal injury and stage Ⅲ ～ Ⅳ xerostomia in experimental group were both significantly lower than those in control group（ all P〈 0. 05） at doses of 40 Gy,70 Gy and 30 d after radiotherapy. Saliva secretion and saliva pH in experimental group were higher than those in control group（ P 〈0. 05）.Conclusion Vitamin C and Kangfuxin liquid can alleviate radiation-induced oral mucosal damage in head and neck cancer patients undergoing radiotherapy.