益气养阴、凉血散瘀法防治老年鼻咽癌放射性口干20例

Prevention and Treatment of 20 Cases of Elderly Nasopharyngeal Carcinoma with Radioactive Dry Mouth by Method of Supplementing Qi and Nourishing Yin and Cooling Blood and Dispersing Stasis

目的:观察益气养阴、凉血散瘀法防治老年鼻咽癌放射性口干的临床疗效。方法:将40例老年鼻咽癌放射性口干患者随机分为对照组和治疗组,每组各20例。对照组仅给予常规放疗方案,治疗组在对照组的基础上,以益气养阴、凉血散瘀为治疗大法给予中药口服。比较两组患者治疗第3周及治疗第6周口干程度、唾液腺损伤程度、卡氏评分、唾液流率及唾液pH值,检测两组患者放疗前后肝功能肾功能[丙氨酸氨基转移酶(alanine transaminase,ALT)、天冬氨酸氨基转移酶(aspartateaminotransferase,AST)、肌酐(serum creatinine,Scr)、血尿素氮(blood urea nitrogen,BUN)]水平变化情况。结果:两组患者治疗前均无口干、唾液腺损伤等症状,第3周出现口干、唾液腺损伤等症状,差异无统计意义(P> 0. 05);第6周治疗组口干、唾液腺损伤等症状较对照组轻,差异具有统计学意义(P <0. 05)。第3周两组患者唾液流率明显下降、pH值显著升高,第6周唾液流率继续降低、pH值持续升高,唾液流率治疗组明显高于对照组,治疗组pH值低于对照组,差异具有统计学意义(P <0. 05)。两组患者卡氏评分、肝功能及肾功能指标比较,差异无统计学意义(P> 0. 05)。结论:益气养阴、凉血散瘀能明显降低老年鼻咽癌患者放疗期间唾液腺损伤程度,缓解患者口干等症状。

Objective： To observe the clinical curative effect of method of supplementing qi and nourishing yin,cooling blood and dispersing stasis on elderly nasopharyngeal carcinoma with radioactive dry mouth by method of supplementing qi and nourishing yin,cooling blood and dispersing stasis. Methods： Forty elderly patients with salivary injury after radiotherapy for nasopharyngeal carcinoma were randomly divided into the control group and the treatment group,with 20 cases in each group. The ones in the control group were only given conventional radiotherapy,while the ones in the treatment group were given TCM for oral administration by method of supplementing qi and nourishing yin,cooling blood and dispersing stasis. The degree of dry mouth,degree of salivary gland damage,Karl＇s score,salivary flow rate and salivary pH value were compared between the two groups at the 3 rdweek and the6 thweek. The changes of liver and kidney function indexes such as alanine aminotransferase（ALT）,aspartate aminotransferase（AST）,serum creatinine（Scr）,blood urea nitrogen（BUN） were measured before and after radiotherapy. Results： The two groups had no symptoms of dry mouth and salivary gland injury before the treatment,and the symptoms of dry mouth and salivary gland injury appeared on the third week,there was no statistical significance（P〈0. 05）. The symptoms of dry mouth and salivary gland injury in the treatment group were lighter than those in the control group on the 6 thweek,and the difference was statistically significant（P〈0. 05）. On the third week,the salivary flow rate of the two groups decreased significantly,and the pH value increased significantly. On the sixth week,the salivary flow rate continued to decrease and the pH value continued to increase. The salivary flow rate of the treatment group was significantly higher than that of the control group,and the pH value of the treatment group was lower than that of the control group. The difference was statistically significant（P〈0. 05 There was no significant difference between the two groups in card score and liver and kidney function（P〈0. 05）. Conclusion： Method of supplementing qi and nourishing yin,cooling blood and dispersing stasis can significantly reduce the degree of salivary gland damage and relieve the symptoms of dry mouth in elderly patients with nasopharyngeal carcinoma during radiotherapy.