滋阴清热方治疗放射性口炎35例临床研究

Clinical Study on Treatment of 35 Cases of Radioactive Stomatitis with Ziyin Qingre Decoction

目的：观察中药滋阴清热方对放射性口炎患者在放射治疗过程中口腔黏膜、唾液中EGF含量及各证候评分的影响。方法：收集2015年11月—2017年3月收治的70例放射性口炎患者,将上述患者按随机数字表法分为对照组和治疗组各35例,对照组患者采用常规西医对症治疗,治疗组患者采用自拟中药滋阴清热方随证加减治疗。治疗过程中及治疗后对两组患者的口腔黏膜分度反应情况、唾液中EGF平均含量及各证候评分进行观察比较。结果：在放疗剂量为30 Gy时,口腔黏膜分度反应对照组Ⅰ度5例占14.29%,Ⅱ度26例占74.29%,Ⅲ度3例占8.57%,Ⅳ度1例占2.86%;治疗组Ⅰ度25例占71.43%,Ⅱ度8例占22.86%,Ⅲ度2例占5.71%,Ⅳ度0例。治疗组明显好于对照组（P〈0.01）。在放疗剂量为70 Gy时,口腔黏膜分度反应对照组Ⅰ度0例,Ⅱ度5例占14.29%,Ⅲ度24例占68.57%,Ⅳ度6例占17.14%;治疗组Ⅰ度8例占22.86%,Ⅱ度22例占62.86%,Ⅲ度4例占11.43%,Ⅳ度1例占2.86%。治疗组明显好于对照组（P〈0.01）。在放疗剂量为0、30、70 Gy时,对照组患者唾液中EGF平均含量分别为（242.57±15.89）pg/mL（89.32±42.15）pg/mL、（40.16±32.85）pg/m、L,治疗组患者唾液中EGF平均含量分别为（223.45±18.76）pg/mL、（170.95±52.84）pg/mL、（126.33±44.79）pg/mL。放疗后治疗组患者唾液中EGF平均含量要明显高于对照组（P〈0.01）。治疗后患者恶心呕吐、食欲减退、气虚乏力、疼痛的证候评分,治疗组明显好于对照组（P〈0.01,P〈0.05）。结论：自拟中药滋阴清热方治疗放射性口炎疗效显著,值得广泛推广。

Objective ：To observe the effect of Ziyin Qingre Decoction on the content of EGF in oral mucosa and saliva and the score of each symptom in patients with radiation stomatitis during radio therapy. Methods ：From November 2015 to March 2017 in our hospital 70 cases of radiation stomatitis patients,the patients were randomly divided into control group and treatment group with 35 cases in each group,the control group was treated with conventional Western medicine treatment,the treatment group was treated with Chinese medicine of nourishing Yin and clearing heat syndrome with the addition and subtraction treatment. In the course of treatment and after treatment,the two groups of patients with oral mucosa division reaction,saliva EGF average content and each syndrome score were observed and compared. Results ：In radiotherapy at the dose of 30 Gy,oral mucosa reaction index control group I 5 cases accounted for 14.29%,26 cases of grade II accounted for 74.29%,3 cases of grade Ⅲ accounted for 8.57%,1 cases of grade Ⅳ accounting for 2.86%;the treatment group grade I 25 cases accounted for 71.43%,8 cases of grade II accounted for 22.86%,2 cases of grade Ⅲ accounted for 5.71%,grade IV in 0 cases. The treatment group was obviously better than that of the control group（P〈0.01）. In radiotherapy at the dose of 70 Gy,oral mucosa reaction index control group gradeⅠ0 cases,5 cases of grade II accounted for 14.29%,24 cases of gradeⅢ accounted for 68.57%,6 cases of gradeⅣaccounting for 17.14%;the treatment group grade I 8 cases accounted for 22.86%,22 cases of grade II accounted for 62.86%,4 cases of grade III accounted for 11.43%. 1 cases of grade IV accounted for 2.86%. The treatment group was obviously better than that of the control group（P〈0.01）. In the radiotherapy dose of 0,30 and 70 Gy,the average content of control group in the saliva of patients with EGF were（242.57±15.89）pg/mL,（89.32±42.15）pg/mL,（40.16±32.85）pg/mL treatment group,the average content in saliva of patients with EGF were（223.45±18.76）pg/mL,（170.95±52.84）pg/mL,（126.33±44.79）pg/mL. The average content of EGF in saliva of the treated group was higher than that of the control group（P〈0.01）. After treatment,the scores of nausea,vomiting,anorexia,weakness of Qi,weakness and pain were significantly higher in the treatment group than in the control group（P〈0.01,P〈0.05）. Conclusion ：The treatment of radiation stomatitis with Chinese medicine nourishing Yin and clearing heat is effective and worth popularizing widely.