加减黄芪防己汤治疗喉癌术后局部放疗并发喉及颈部迟发性淋巴水肿临床研究

Effect of adding and subtracting Huangqi Fangji decoction on delayed lymphedema of laryngeal and neck caused by local radiotherapy after laryngeal cancer surgery

目的:探讨加减黄芪防己汤在喉癌术后局部放疗引起喉及颈部的迟发性淋巴水肿的疗效。方法:选取喉癌术后放疗患者90例作为主要研究对象,按随机数字表法分为观察组和对照组,每组45例,均为男性,对照组患者进行常规放疗,观察组患者在对照组放疗基础上给予黄芪防己汤加减。比较两组患者因放疗引起的喉及颈部的迟发性淋巴水肿治疗效果。结果:观察组患者放疗引起喉淋巴的水肿分级及LENT-SOMA评分大部分处于0~2级,而对照组患者大部分处于3~4级,两组淋巴水肿反应分级比较,差异具有统计学意义(P<0.05);观察组患者放疗引起的颈部淋巴的水肿改良Miller评分大部分处于0~2级,而对照组患者大部分处于2~3级,两组淋巴水肿反应分级比较,差异具有统计学意义(P<0.05);治疗前,两组患者VAS评分比较,差异不具有统计学意义(P>0.05)。治疗后,观察组及对照组患者的VAS评分均较治疗前下降明显,差异具有统计学意义(P<0.05),观察组患者低于对照组患者,两组比较差异有统计学意义(P<0.05)。结论:黄芪防己汤加减治疗喉癌术后局部放疗引起的喉及颈部的迟发性淋巴水肿的疗效值得肯定,患者在放疗结束后的淋巴水肿情况明显改善,且病程较单纯放疗明显缩短,有利于患者的长期预后。

Objective:To explore the effect of adding and subtracting Huangqi Fangji decoction on delayed lymphedema of the throat and neck caused by local radiotherapy after laryngeal cancer surgery.Methods: 90 patients with postoperative radiotherapy for laryngeal cancer were selected as the main subjects. They were divided into observation group and control group according to the random number table method. Each group of 45 patients were male. The control group received routine radiotherapy and the observation group received radiotherapy in the control group. On the basis of the addition of Huangqi Fangji decoction. The therapeutic effects of delayed lymphedema in the throat and neck caused by radiotherapy were compared between the two groups.Results:The edema grade and LENT-SOMA scores of the laryngeal lymph nodes in the observation group were mostly in the 0~2 grade,while the majority of the control group were in the 3~4 grade. The lymph node edema reaction grades of the two groups were statistically significant ( P <0.05). Most of the Miller scores of the cervical lymph nodes caused by radiotherapy in the observation group were in grade 0~2,while the majority of the control group were in grades 2~3. The lymph node edema response was compared between the two groups. The difference was statistically significant( P <0.05);before treatment,the VAS scores of the two groups were not statistically significant ( P >0.05). After treatment,the VAS scores of the observation group and the control group were significantly lower than those before the treatment,the difference was statistically significant ( P <0.05),and the observation group was lower than the control group. The difference between the two groups was statistically significant ( P <0.05).Conclusion:The efficacy of Huangqi Fangji decoction in the treatment of delayed lymphedema of the laryngeal and neck caused by local radiotherapy after laryngeal cancer surgery is worthy of affirmation. The patient's lymphedema after the end of radiotherapy is obviously improved,and the course of disease is significantly shorter than that of radiotherapy alone. The long-term prognosis of patients.