会厌逐瘀汤加味对喉鳞状细胞癌术后恢复的效果观察

Clinical effect of Jiawei Huiyan Zhuyu decoction in postoperative recovery of laryngeal squamous cell carcinoma

目的:探讨会厌逐瘀汤加味对喉鳞状细胞癌(LSCC)术后恢复的效果。方法:将60例LSCC术后患者按照随机数字表法分为治疗组和对照组,每组各30例。对照组给予常规抗感染治疗,治疗组于术后1个月开始配合会厌逐瘀汤加味口服治疗,每年服用1个月,连续治疗3年。于术后4个月观察比较2组呼吸、吞咽、语言交流功能恢复情况及疼痛视觉模拟评分法(VAS)评分,于术后观察2组并发症发生率,术后3年随访2组复发率和生存率。结果:术后4个月,治疗组呼吸功能正常者86.67%(26/30),吞咽功能正常者80.00%(24/30),语言交流正常者86.67%(26/30),对照组分别为63.33%(19/30)、50.00%(15/30)、60.00%(18/30),两两比较,差异均有统计学意义(P<0.05);术后4个月2组VAS评分均较术前降低,且治疗组降低幅度更大,差异均有统计学意义(P<0.01);2组术后均未出现咽瘘、出血、感染等并发症;术后3年随访结果显示,复发率治疗组为16.67%(5/30),对照组为40.00%(12/30),2组比较,差异有统计学意义(P<0.05);3年后的生存率治疗组为90.00%(27/30),对照组为66.67%(20/30),2组比较,差异有统计学意义(P<0.05)。结论:会厌逐瘀汤加味可促进喉癌术后患者呼吸、吞咽、语言交流功能的恢复,减少患者疼痛,提高生活质量,长期用药可降低复发率并提高生存率。

Objective: To investigate the clinical effect of Jiawei Huiyan Zhuyu decoction in postoperative recovery of laryngeal squamous cell carcinoma(LSCC).Methods: A total of 60 LSCC patients after surgery were divided into treatment group and control group using a random number table, with 30 patients in each group.The patients in the control group were given conventional anti-infective therapy, and in addition to the treatment in the control group, those in the treatment group were given oral administration of Jiawei Huiyan Zhuyu decoction at 1 month after surgery, 1 month every year for 3 consecutive years.At 4 months after surgery, the two groups were compared in terms of the functional recovery of respiration, swallowing, and verbal communication and Visual Analogue Scale(VAS) score;the incidence rate of complications was observed after surgery;both groups were followed up for 3 years after surgery to observe recurrence rate and survival rate.Results: At 4 months after surgery, there were significant differences between the treatment group and the control group in the proportion of patients with normal respiratory function [86.67%(26/30) vs 63.33%(19/30),P<0.05],normal swallowing function [80.00%(24/30) vs 50.00%(15/30),P<0.05],or normal verbal communication [86.67%(26/30) vs 60.00%(18/30),P<0.05].At 4 months after surgery, both groups had a significant reduction in VAS score, and the treatment group had a significantly greater reduction than the control group(P<0.01),and no complications such as pharyngeal fistula, bleeding, and infection were observed in either group.The results of 3-year follow-up showed that there were significant differences between the treatment group and the control group in recurrence rate [16.67%(5/30) vs 40.00%(12/30),P<0.05] and survival rate after 3 years [90.00%(27/30) vs 66.67%(20/30,P<0.05].Conclusion: For patients after surgery for laryngocarcinoma, Jiawei Huiyan Zhuyu decoction can promote the functional recovery of respiration, swallowing, and verbal communication, reduce pain, and improve quality of life, and long-term medication can reduce recurrence rate and improve survival rate.