参麦注射液雾化吸入联合益气养阴法治疗鼻咽癌放射性口腔黏膜炎疗效及对血清乏氧诱导因子-1α和血管内皮生长因子的影响

Effect of Shenmai Injection for atomization inhalation combined with supplementing Qi and nourishing Yin therapy in the treatment of radioactive oral mucositis of nasopharyngeal carcinoma and its influence on serum hypoxia inducible factor-1α and vascular

目的观察参麦注射液雾化吸入联合益气养阴疗法治疗鼻咽癌放射性口腔黏膜炎的临床疗效及对乏氧诱导因子-1α(HIF-1α)及血管内皮生长因子(VEGF)的影响。方法将110例鼻咽癌患者随机分为观察组55例和对照组55例,2组患者均给予放射治疗,在开始放射治疗后,对照组给予1∶1 000浓度的氯己定漱口,并给予思密达用水搅拌至浆糊状后,均匀涂抹至口腔黏膜侧;观察组给予参麦注射液雾化吸入联合口服益气养阴方治疗,至放疗结束。统计2组临床疗效,比较口腔炎出现的时间、严重程度及口腔炎缓解时间,观察2组治疗前后口腔p H值、VAS评分及血清HIF-1α、VEGF水平变化情况。结果观察组临床总有效率显著高于对照组(P<0.05),口腔炎反应出现时间显著长于对照组(P<0.05),口腔炎缓解时间显著快于对照组(P<0.05),黏膜反应程度显著轻于对照组(P<0.05)。治疗后,2组口腔p H值、VAS评分和血清HIF-1α、VEGF水平均明显降低(P均<0.05),且观察组下降的幅度更大(P均<0.05)。结论参麦注射液雾化吸入联合益气养阴疗法可减轻因放射治疗导致的口腔黏膜的炎性损伤,提高患者的治疗依从性,保证放疗治疗的顺利开展。

Objective It is to observe the effect of Shenmai Injection for atomization inhalation combined with supplementing Qi and nourishing Yin therapy in the treatment of radioactive oral mucositis of nasopharyngeal carcinoma and its influence on hypoxia inducible factor-1α（ HIF-1α） and vascular endothelial growth factor（ VEGF）. Methods One hundred and ten patients with nasopharyngeal carcinoma were randomly divided into observation group（ 55 cases） and control group（ 55 cases）,all patients were given radiation therapy. After the start of radiation therapy,the control group was given 1∶ 1 000 concentration of chlorhexidine to gargle,and then give Smecta water paste to smear to the oral mucosa. The observation group was treated with aerosol inhalation of Shenmai Injection combined with supplementing Qi and nourishing Yin decoction. The clinical curative effect of the two groups were evaluated; the onset time and severity of stomatitis,and the remission time of stomatitis were recorded in the two groups; the changes of oral p H,VAS and serum HIF-1α and VEGF levels were observed before and after treatment in the two groups. Results The total effective rate of the observation group was significantly higher than that of the control group（ P〈 0. 05）,the onset time of stomatitis was significantly longer than that of the control group（ P〈 0. 05）,the remission time of stomatitis was significantly faster than that of the control group（ P〈 0. 05）,the degree of stomatitis was less than that of the control group（ P〈 0. 05）. After treatment,the oral p H,VAS score and serum HIF-1α and VEGF levels of the two groups were significantly decreased（ all P〈 0. 05）,and the decrease of the observation group was greater（ P〈 0. 05）. Conclusion Atomization inhalation of Shenmai Injection combined with supplementing Qi and nourishing Yin therapy can reduce the inflammatory injury of oral mucosa caused by radiotherapy,and improve the compliance of patients with treatment,ensure the smooth development of radiotherapy.