九节茶含漱液联合益胃汤加减治疗放射性口腔黏膜炎的疗效观察

Efficacy of Jiujiecha Gargle Combined with Modified Yiwei Decoction in the Treatment of Radiation-Induced Oral Mucositis

目的:探讨九节茶含漱液联合益胃汤加减治疗放射性口腔黏膜炎的临床疗效。方法:选取2017年3月至2020年3月于黔南州中医医院放疗后出现放射性口腔黏膜炎的118例头颈部恶性肿瘤患者作为研究对象,采用随机数字表法分为观察组和对照组,每组59例。在常规治疗的基础上,对照组患者采用复方氯己定含漱液治疗,观察组患者采用九节茶含漱液联合益胃汤加减治疗。观察两组患者的临床疗效,治疗前和治疗1、2个月后(治疗1个月,随访1个月)口咽部疼痛数字评价量表(numerical rating scale,NRS)评分,治疗前和治疗1个月后炎症因子水平,愈合时间、真菌感染发生情况和血液不良反应发生情况。结果:观察组患者的总有效率为93.22%(55/59),明显高于对照组的79.66%(47/59),差异有统计学意义(P<0.05)。两组患者治疗后的转化生长因子β1、肿瘤坏死因子α、C-反应蛋白水平和NRS评分较治疗前明显降低,且观察组患者较对照组降幅更大,差异均有统计学意义(P<0.05)。与对照组相比,观察组患者的愈合时间更短,真菌感染发生率更低,差异均有统计学意义(P<0.05)。观察组患者白细胞减少3级及以上、淋巴细胞减少3级及以上的发生率均明显低于对照组,差异均有统计学意义(P<0.05)。结论:九节茶含漱液联合益胃汤加减可有效治疗放射性口腔黏膜炎,降低炎症因子水平,降低真菌感染发生率和血液系统不良反应发生率,改善疼痛。

OBJECTIVE:To probe into the clinical efficacy of Jiujiecha gargle combined with modified Yiwei decoction in the treatment of radiation-induced oral mucositis.METHODS:A total of 118 patients with head and neck cancer who developed radiation-induced oral mucositis in Qiannan Buyei and Miao Autonomous Prefecture Traditional Chinese Medicine Hospital from Mar.2017 to Mar.2020 were extracted to be divided into the observation group and the control group via the random number table,with 59 cases in each group.On the basis of conventional treatment,the control group was treated with compound chlorhexidine gargle,while the observation group received Jiujiecha gargle combined with modified Yiwei decoction.The clinical efficacy,numerical rating scale(NRS)score for oropharyngeal pain before treatment and after treatment of 1 and 2 months(treatment for 1 month and follow-up for 1 month),levels of inflammatory factors,healing time,occurrence of fungal infection and occurrence of adverse blood reactions before and after treatment of 1 month in two groups were observed.RESULTS:The total effective rate of the observation group was 93.22%(55/59),significantly higher than 79.66%(47/59)of the control group,the difference was statistically significant(P<0.05).After treatment,the levels of transforming growth factorβ1,tumor necrosis factorα,C-reactive protein and NRS score in two groups decreased significantly compared with before treatment,and the decrease in the observation group was greater than that in the control group,the differences were statistically significant(P<0.05).Compared with the control group,the healing time was shorter and the incidence of fungal infection was lower in the observation group,with statistically significant difference(P<0.05).The incidence of leukopenia and lymphopenia of grade 3 and above in the observation group was lower than that in the control group,the differences were statistically significant(P<0.05).CONCLUSIONS:Jiujiecha gargle combined with modified Yiwei decoction can effectively treat the radiation-induced oral mucositis,reduce the level of inflammatory factors,the incidence of fungal infection and adverse blood reactions,and improve pain of patients.