中药清瘤亮喉方辅助治疗喉咽癌的临床观察  

Adjunctive Therapy of Hypopharyngeal Carcinoma by Qingliu Lianghou Recipe

作　　者：陈万军[1] 汪冰[2] 韩秀丽[2] 

机构地区：[1]山东省医学科学院,山东省肿瘤医院头颈科,济南250117 [2]山东中医药大学附属医院耳鼻喉科,济南250011

出　　处：《中国中西医结合杂志》2012年第7期892-895,共4页Chinese Journal of Integrated Traditional and Western Medicine

基　　金：山东省优秀中青年科学家科研奖励基金项目(No.2008BS03034);山东省中医药科技发展计划项目(No.2009-101)

摘　　要：目的探讨中药清瘤亮喉方在喉咽癌综合治疗中的辅助作用。方法喉咽鳞状细胞癌患者 156例,其中Ⅰ期 21 例、Ⅱ期 34 例、Ⅲ期 55 例、Ⅳ期 46 例; 行手术加放疗( 简称 A 组) 31 例,手术加放疗加中药清瘤亮喉方( 简称 B 组) 40 例,放疗加化疗( 简称 C 组) 45 例,放疗加化疗加中药清瘤亮喉方( 简称 D 组) 40例。中药疗程均为 12 周。观察各组放、化疗毒性反应、生活质量评分( KPS 评分) 及远期疗效( 复发及生存时间) 。结果 B 组较 A 组毒性反应分级降低,表现在放射性皮炎、口腔黏膜炎、吞咽困难、体重变化、颈部淋巴水肿方面( P <0. 05,P <0. 01) ; D 组较 C 组毒性反应分级显著降低,主要表现在放射性皮炎、口腔黏膜炎、吞咽困难、骨髓抑制、消化道反应、体重变化方面( P < 0. 05,P < 0. 01) 。所有患者治疗后 KPS 评分均降低( P <0. 05,P <0. 01) ,但 B 组患者 KPS 评分高于 A 组患者( P <0. 05) ,D 组高于 C 组( P <0. 05) 。A 组患者3 年复发率及5 年生存率分别为41. 94%及38. 71%,B 组分别为20. 00%及62. 50%( P <0. 05) ; C 组分别为 60. 00%及 22. 22%,D 组分别为 37. 50%及 42. 50%( P <0. 05) 。结论清瘤亮喉方能有效地预防和减轻手术、放疗、化疗的毒性反应,结合手术、放疗、化疗治疗喉咽癌可降低肿瘤复发率,延长患者的寿命。其对喉咽癌的辅助治疗作用不容忽视。Objective To study the adjunctive roles of Qingliu Lianghou Recipe （QLR） in treatment of hy- popharyngeal carcinoma. Methods A total of 156 patients with hypopharyngeal squamous cell carcinoma were recruited, including 21 cases of stage i , 34 in stage IT, 55 in stage m, and 46 in stage IV. Of them, 31 pa- tients （Group A） were managed with operation and post-operative radiotherapy, 40 patients （Group B） with op- eration, post-operative radiotherapy, and QLR, 45 patients （Group C） were managed with concomitant chemo- radiotherapy, 40 patients （Group D）with concomitant chemoradiation and QLR. QLR was given for 12 weeks. The radio-and chemicotoxic reactions, quality of life （KPS score）, and long-term efficacy （the recurrence time and the survival time） were observed. Results The toxicity levels were significantly lower in Group B than in Group A, manifested as radioactive dermatitis, mucositis, dysphagia, changes in body weight, and lymphatic e- dema （ P〈0.05, P〈0.01 ）. The toxicity levels were significantly lower in Group D than in Group C, manifested as radioactive dermatitis, mucositis, dysphagia, marrow depression, changes in body weight, and gastrointesti- nal reactions （ P 〈 0. 05, P 〈 0. 01 ）. After treatment the KPS scores of all patients obviously decreased （ P 〈 0.05, P〈0.01 ）. But the KPS scores were significantly higher in Group B than in Group A （P〈0.05）, and they were significantly higher in Group D than in Group C （ P〈0. 05）. The 3-year recurrence rate of patients in Group A was 41.94%, 20.00% in Group B, 60.00% in Group C, and 37.50% in Group D （P〈0.05）. The 5-year survival rate of patients in Group A was 38.71%, 62.50% in Group B, 22.22% in Group C, and 42.50% in Group D （ P 〈 0. 05）. Conclusions QLR could effectively prevent and reduce the toxicity response caused by op- eration, radiotherapy and chemotherapy. The combination therapy of integrative medicine could postpone the re- currence and prolonq the lifesl^an of I^ati

关 键 词：喉咽 肿瘤 清瘤亮喉方 

分 类 号：R739.65[医药卫生—肿瘤]