养阴生津法防治鼻咽癌放疗所致口腔黏膜反应41例临床观察

Observation on Preventing and Controlling Mouth Mucositis of 41 Cases with Therapy of Nourishing Yin to Produce Body Fluid After Radiotherapy of Nasopharyngeal Cancer

目的 观察中药对鼻咽癌放疗所致口腔黏膜反应的防治效果。方法 将经病理确诊为鼻咽癌并接受放疗的患者 4 1例 ,随机分成治疗组 (放疗 +中药 )和对照组 (单纯放疗 )。两组病例均按常规分割方法放疗 (2 0Gy/次 ,5次 /周 ) ,总量 (34～ 35次 ;6 8～ 70Gy)。治疗组于放射治疗前 1周开始服用养阴生津方药 (药物组成为 :太子参 2 0g ,北沙参 15g ,玄参 15g ,天花粉 15g ,生地 15g ,百合 12g ,金银花 15g ,山豆根 9g ,麦冬 10g ,陈皮 8g ,鸡内金 12g ,生黄芪 2 0g ,女贞子 15g ,丹参 15g ,川芎 9g ,红花 9g ,生草 5g) ,直至全程放疗结束后 1周。观察放疗后口腔黏膜反应情况。结果 放疗至第 3周末 ,治疗组以 1级反应为主 ,对照组以 2级反应为主 ,两组差异显著 (P <0 0 5 )。放疗至第 7周末时 ,对照组以 3、4级黏膜的反应为主 ,治疗组以 2级反应为主 ,两组差异显著 (P <0 0 5 )。结论 中药配合放疗能够有效防治口腔黏膜反应、推迟放射性口腔炎发生的时间 。

Objective The effectiveness of Chinese herbs on preventing and controlling mouth mucositis caused by nasopharyngeal cancer was observed. Method Forty one cases diagnosed as nasopharyngeal cancer and treated with radiotherapy were divided randomly into the treatment group treated with radiotherapy and herbs and the control group treated with radiotherapy only. The cases in two groups were all given radiotherapy according to a routine fractionated radiation, which was 2 0Gy/t and 5 times a week. The total volume was 68-70Gy/34-35t. The treatment group was given Chinese herbs with effectiveness of nourishing yin to produce body fluid from one week before radiotherapy applied till one week after radiotherapy applied. The herbs included 20 g pseudostellaria root, 15 g glehnia root, 15 g scrophularia root, 15 g trichosanthes root, 15 g dried rehmanria root, 12 g lily bulb and so on. Then the reaction of mouth mucous membrane after radiotherapy were observed. Result At the end of the third week the reactions of the cases in the treatment group were mainly grade 1, while in the control group, grade 2 mainly. The difference was significant ( P <0 05). At the end of the 7th week the reactions of the cases in the control group were mainly grade 3 or grade 4, while in the treatment group, grade 2 mainly. The difference was significant ( P <0 05). Conclusion Radiotherapy coordinated with Chinese herbs can effectively prevent and control the reaction of mouth mucous membrane, defer occurring of mouth mucositis and help the patients to complete radiotherapy smoothly.