养阴祛邪法治疗鼻咽癌放疗后口干症的效果

Effect of nourishing yin and removing pathogenic factors in the treatment of xerostomia after radiotherapy of nasopharyngeal carcinoma

目的探讨中药养阴祛邪法治疗鼻咽癌放疗后口干症的临床效果。方法选取2016年10月~2018年10月于重庆大学附属肿瘤医院就诊的鼻咽癌放疗后口干症患者84例,根据随机数字表法将其分为对照组和治疗组,各42例。对照组采用根治性放疗鼻咽部总剂量68~76 Gy+康复新液10 mL含服,3次/d。治疗组在对照组基础上加养阴祛邪中药。两组均以1个月为1个疗程,共治疗3个疗程。观察两组治疗前后口干程度评分、刺激性唾液流量及腮腺血流超声检测值[动脉的收缩期峰值血流速度(PSV)、动脉舒张末期血流速度(EDV)、血管阻力指数(RI)和血管内径(D)缩小比例]。结果治疗后,两组口干程度评分均低于治疗前,刺激性唾液流量均多于治疗前,且治疗组改善较对照组显著,差异有统计学意义(P <0.05或P <0.01)。治疗组放疗后1个月的PSV、EDV和D缩小比例比较均低于放疗第3周,差异有统计学意义(P <0.05)。治疗组放疗后1个月的PSV、EDV和D缩小比例均低于对照组,差异有统计学意义(P <0.05)。结论养阴祛邪法可明显改善鼻咽癌放疗后口干症患者的口干症状,对唾液腺有较好的保护作用。

Objective To investigate clinical efficacy of nourishing yin and removing pathogenic factors in treating patients with xerostomia after radiotherapy for nasopharyngeal carcinoma. Methods From October 2016 to October 2018,84 patients with xerostomia after radiotherapy for nasopharyngeal carcinoma were selected from Chongqing University Cancer Hospital. According to the random number table method, they were divided into control group and treatment group, with 42 cases in each group. Total dose of nasopharynx was 68-76 Gy + 10 mL of Kangfuxin Solution, three times a day was in control group. On the basis of control group, treatment group was added with traditional Chinese medicine for nourishing yin and eliminating pathogenic factors. Two groups were treated with one month as a course of treatment, a total of three courses of treatment. The dry mouth score, stimulated salivary flow and parotid flow(PSV,EDV, RI, D) between two groups were observed before and after treatment. Results After treatment, the score of dry mouth degree in two groups was lower than that before treatment, and stimulating saliva flow was more than that before treatment, and the improvement in treatment group was more significant than that in control group(P < 0.05 or P <0.01). The PSV, EDV and D at the first month after radiotherapy in treatment group were lower than those at the third week after radiotherapy, there were significant differences(P < 0.05). The PSV, EDV and D at the first month after radiotherapy in the treatment group were lower than those of control group, there were significant differences(P < 0.05).Conclusion The method of nourishing yin and removing pathogenic factors can obviously improve the symptoms of xerostomia of nasopharyngeal carcinoma patients after radiotherapy, and has a better protective effect on salivary gland.