The Standardization of Acupuncture Treatment for Radiation-Induced Xerostomia:A Literature Review

Objective： To assess the relative standardization of acupuncture protocols for radiation-induced xerostomia. Methods： A literature search was carried out up to November 10, 2012 in the databases PubMed/ MEDLINE, EMBASE and China National Knowledge Infrastruction with the terms： radiation-induced xerostomia, acupuncture, acupuncture treatment, and acupuncture therapy. Five ancient Chinese classic acupuncture works were also reviewed with the keywords ＂dry mouth, thirst, dry tongue, dry eyes and dry lips＂ to search the effective acupuncture points for dry mouth-associated symptoms in ancient China. Results： Twenty-two full-text articles relevant to acupuncture treatment for radiation-induced xerostomia were included and a total of 48 acupuncture points were searched in the 5 ancient Chinese classic acupuncture works, in which the most commonly used points were Chengjiang （CV24）, Shuigou （GV 26）, Duiduan （GV 27）, Jinjin （EX-HN 12）, and Yuye （EX-HN 13） on head and neck, Sanjian （LI 3）, Shangyang （LI 1）, Shaoshang （LU 11）, Shaoze （SI 1）, Xialian （LI 8） on hand, Fuliu （KI 7）, Dazhong （KI 4）, Zuqiaoyin （GB 44）, Taichong （LR 3）, Zhaohai （KI 6） on foot, Burong （ST 19）, Zhangmen （LR 13）, Tiantu （CV 22）, Qimen （LR 14） on abdomen, Feishu （BL 13）, Danshu （BL 19）, Xiaochaogshu （BL 27）, Ganshu （BL 18） on back, Shenmen （TF 4）, Shen （CO10, Kidney）, Yidan （CO11, Pancreas） and Pi （CO13, Spleen） on ear. Conclusion： There were considerable heterogeneities in the current acupuncture treatment protocols for radiation-induced xerostomia. Based on the results of the review and the personal perspectives, the authors provide a recommendation for manual acupuncture protocols in treating radiationinduced xerostomia patients with head and neck cancer.

桑葚羹防治放射性口腔干燥的临床研究

目的:观察桑葚羹防治放射性口腔干燥(radiation-induced xerostomia,RX)的临床疗效。方法:采用多中心、前瞻、双盲随机对照的临床设计,将90例接受放疗的头颈部肿瘤患者随机分为治疗组和对照组,治疗组放疗同时服用桑葚羹,对照组服用安慰剂,直至放疗结束。观察两组口干症状评分、口腔粘膜反应评分、口腔疼痛评分、口腔干燥出现时间、接受的放射剂量、LASA生活质量评分、karnofsky评分以及安全性指标。结果:最终纳入可评价患者80例,治疗组39例,对照组41例。两组患者在年龄、性别、放疗后辨证分型、接受的放射剂量等一般情况均无统计学差异(P>0.05)。治疗组患者从21 d开始至试验结束,口干评分、口腔粘膜反应评分、口腔疼痛评分均明显低于对照组(P<0.05),而两组患者口干出现的时间和放射剂量均无统计学差异(P>0.05)。试验结束时治疗组KPS评分明显高于对照组(P<0.05),而LASA生活质量量表中食欲、睡眠两个维度评分治疗组明显高于对照组(P<0.05),一般活动、精神状态、情绪、与人交往、生活兴趣、总分等方面两组之间无统计学差异(P>0.05)。两组患者试验过程中RBC、HB、WBC、PLT、ALT、AST、BIL、BUN、Cr等指标均无统计学差异(P>0.05)。结论:持续口服3 w后,桑葚羹可有效减轻放射性口腔干燥,改善患者食欲、睡眠,提高患者生活质量,且临床应用安全可靠。