丹参多酚酸盐联合克拉霉素治疗鼻咽癌放疗后鼻-鼻窦及咽部损伤的疗效及对患者口腔黏膜CINC-1和TLR-9表达的影响

Effect of salvianolic acid combined with clarithromycin on posterior nasal-paranasal sinus and pharynx injuries after radiotherapy for nasopharyngeal carcinoma and its effect on the expression of CINC-1 and TLR-9 in oral mucosa

目的观察丹参多酚酸盐联合克拉霉素治疗鼻咽癌放疗后鼻-鼻窦及咽部损伤的疗效及对口腔黏膜CINC-1和TLR-9的影响。方法将行根治性放疗的90例鼻咽癌患者随机分为观察组45例和对照组45例,对照组给予维生素B_(12)2 500μg鼻腔冲洗和克林霉素口服,观察组给予丹参多酚酸盐注射液200 mg+维生素B_(12)2 500μg鼻腔冲洗和克林霉素口服,2组均连续治疗1个月。观察并比较2组治疗前后临床症状积分、视觉模拟量表(VAS)评分、纤毛传输速率、鼻内镜检查及鼻窦CT评分及口腔黏膜组织中CINC-1和TLR-9表达水平的变化,统计2组临床疗效、放疗后放射性鼻窦炎的发生率。结果治疗后,2组临床症状评分、VAS评分及口腔黏膜组织中CINC-1和TLR-9水平均显著低于治疗前(P均<0.05),纤毛传输速率、鼻内镜检查及鼻窦CT评分均显著高于治疗前(P均<0.05),且观察组治疗后各项指标改善情况均优于对照组(P均<0.05)。观察组临床总有效率显著高于对照组(P<0.05),治疗结束后3个月及6个月内放射性鼻窦炎发生率显著低于对照组(P均<0.05)。结论丹参多酚酸盐联合克拉霉素治疗鼻咽癌放疗后鼻-鼻窦及咽部损伤疗效确切,可有效缓解黏膜炎症状态,促进患者黏膜功能的恢复,疗效优于单纯克拉霉素治疗。

Objective It is to observe the curative effect of salvianolic acid combined wiment of posterior nasal- paranasal sinus and pharynx injuries after radiotherapy of nasopharyngeal carcinoma and its influ-ence on CINC-1 and TLR-9 of oral mucosa. Metliods 90 patients with nasopharyngeal carcinoma undergoing radical radio-therapy were randomly divided into the observation group （45 ca se s） and the treated with vitamin B 12 for nasal irrigation and clindamycin for oral administration in the control group, and with salvianol-ic acid injection ＋ vitamin Bn for nasal irrigation and clindamycin for oral administration in the observation group. The 2groups were treated continuously for 1 months. The clinical symptom score, visual analogue scale （VAS） score, ciliumtransmission rate, nasal endoscopy and CT score of nasal sinus, and the expression of CINC-1 and TLR-9 in oral mucosa were observed and compared before and after treatment in the 2 groups. The clinical curative effect and incidence of radia-tion rhinosinusitis after radiotherapy were compared between the 2 groups. Results After score , VAS score and the levels of CINC-1 and TLR-9 in oral mucosa tissues of the 2 groups were significantly lower than those before treatment （al l P 〈 0. 05 ） , the cilium transmission rate , endoscopic examination and sinus CT score were sig-nificantly higher than those before treatment （a l l P 〈0. 05） , and the improvement of the indicators in was significantly better than that in the control group after treatment （P 〈 0. 05 ） . The total effective rate of the observation group was significantly higher than that of the control group （P 〈0.05）. The incidence of and 6 months after treatment was significantly lower than that in the control group （ P 〈 0. 05）. Conclusion Salvianolic acidcombined with clarithromycin is effective in treating posterior nasal-paranasal sinus and pharynx injuries after radiotherapy of nasopharyngeal carcinoma. It can efectively alleviate mucosal inflammation and promote the recovery of mucosal func-tion. The curative effect is better than that of clarithromycin.