黄连膏联合局部高压氧喷对食管癌放射性皮肤损伤疗效

Effect of Huanglian ointment combined with local hyperbaric oxygen spray on radiation-induced skin damage in patients with esophageal cancer

目的分析黄连膏联合局部高压氧喷对食管癌放射性皮肤损伤(RISI)的疗效及对患者血清白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、表皮生长因子(EGF)的影响。方法通过便利抽样法回顾性研究潍坊市中医院肿瘤科2021年1月至2022年1月住院的82例食管癌RISI患者,根据治疗方法的不同分组,给予局部高压氧喷治疗的41例为对照组,给予黄连膏联合局部高压氧喷治疗的41例为观察组,比较两组临床疗效、治疗后皮肤损伤严重程度分级、血清IL-6、TNF-α、EGF水平、换药次数、皮损愈合时间、特应性皮炎积分(SCORAD)改良版评分、视觉模拟自评量表(VAS)评分、瘢痕形成率、放射性皮肤感染率。结果观察组临床总有效率(95.12%)高于对照组(68.29%)(P<0.01);治疗后皮肤损伤分级优于对照组(P<0.05);治疗后血清IL-6、TNF-α均低于对照组(P<0.05),血清EGF高于对照组(P<0.05);换药次数低于对照组(P<0.05),皮损愈合时间短于对照组(P<0.05);治疗后SCORAD改良版评分、VAS评分均低于对照组(P<0.05)。放射性皮肤感染率(2.44%)低于对照组(19.51%)(P<0.05)。结论黄连膏联合局部高压氧喷可有效改善食管癌RISI患者皮损状况,减少换药次数,缩短皮损愈合时间,减轻炎症反应及疼痛感,降低放射性皮肤感染率,临床疗效显著。

Objective To analyze the effects of Huanglian ointment combined with local hyperbaric oxygen(HBO)spray on radiation-induced skin injury(RISI)and the levels of serum interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)and epidermal growth factor(EGF)in patients with esophageal cancer.Methods A retrospective study was performed on 82 esophageal cancer patients with RISI admitted to Weifang Hospital of Traditional Chinese Medicine from January 2021 to January 2022 using convenience sampling method.Forty-one patients who received local hyperbaric oxygens pray were divided into control group,while 41 patients who received Huanglian ointment combined with local hyperbaric oxygens pray were divided into observation group.The following indicators were compared between two groups,including clinical efficacy,skin injury severity grading after treatment,levels of serum IL-6,TNF-αand EGF,dressing changes,skin lesion healing time,modified scoring atopic dermatitis(SCORAD)index,visual analogue scale(VAS),scarring rate and radiation-induced skin infection rate.Results The total clinical effective rate in observation group was significantly higher than that in control group(95.12%vs 68.29%,P<0.01).After treatment,the grading of skin damage in observation group was superior to that in control group(P<0.05),the serum levels of IL-6 and TNF in observation group were significantly lower than that in control group(P<0.05),and the EGF level was higher than that in control group(P<0.05).Compared with control group,the number of dressing changes significantly reduced,and the healing time of skin lesions was shortened significantly in observation group(P<0.05).The modified SCORAD score,VAS and radiation-induced skin infection rate(2.44%vs 19.51%)in observation group were statistically lower than those in control group(P<0.05).Conclusion Huanglian ointment combined with local HBO spray can effectively improve the skin condition of RISI patients with esophageal cancer,reduce the frequency of dressing changes,shorten the healing time of skin lesions,reduce inflammatory reactions and pain,and reduce the rate of radiation skin infection.The clinical efficacy is significant.