口腔溃疡防护剂在防治鼻咽癌放射性口腔黏膜炎及对血清炎性因子影响的临床研究  

Clinical study of the effect of oral ulcer protective agent on the prevention and treatment of radioactive oral mucositis in nasopharyngeal carcinoma and serum inflammatory factors

作　　者：黄光[1] 李昭君 孔繁忠[1] 林少民[1] 符起亚[2] Department of Radiotherapy, Hainan Provincial People＇s Hospital, Haikou 570311, China(Huang G, Li Z J, Kong FZ, Lin SM ） ; Department of stomatology, First Affiliated Hospital of Hainan Medical College, Haikou 570102, China （ Fu QY)

机构地区：[1]海南省人民医院放疗科,海口570311 [2]海南医学院第一附属医院口腔科,海口570102

出　　处：《中华放射肿瘤学杂志》2018年第4期360-364,共5页Chinese Journal of Radiation Oncology

基　　金：海南省计生卫生科研项目（16A200048）

摘　　要：目的 研究鼻咽癌调强放疗中口腔溃疡防护剂防治放射性口腔黏膜炎的有效性及其对血清炎性因子的影响。方法 选取我院放疗致1级口腔黏膜炎的鼻咽癌患者90例,随机分为两组,实验组给予口腔溃疡防护剂治疗,对照组给予康复新液治疗。两独立样本t检验比较两组放射性口腔黏膜炎发生时间和程度、VAS 疼痛评分、血清CRP、TGF-β1、IL-6水平及T淋巴细胞亚群水平。结果 两组第4、6周末,实验组2、3级黏膜炎发生率均低于对照组（P=0.018、0.021、0.027、0.014）;实验组VAS疼痛评分中、重度疼痛患者发生率均比对照组减少（P=0.019、0.025）。治疗后两组CRP水平均降低,且实验组低于对照组（P=0.013）;对照组TGF-β1、IL-6水平均升高（P=0.015、0.021）,实验组均降低（P=0.012、0.019）;两组CD3（＋）、CD4（＋）、CD8（＋）、CD4（＋）/CD8（＋）均显著增加,实验组增多更明显（P=0.024、0.036、0.029、0.017）。结论 口腔溃疡防护剂能有效抑制鼻咽癌放化疗患者口腔黏膜损伤的进展,缩短口腔黏膜愈合时间以及缓解疼痛,值得临床推广应用。Objective To evaluate the clinical efficacy of oral ulcer protective agent in the prevention and treatment of oral mucositis in nasopharyngeal carcinoma （NPC） radiotherapy and its effect upon serum inflammatory factors. Methods A total of 90 patients diagnosed with nasopharyngeal carcinoma presenting with grade I oral mucositis caused by radiotherapy in our hospital were selected and randomly divided into two groups. In the experimental group, oral ulcer protective agent was given, and Kangfuxin gargle was administered in the control group. The incidence time and degree of radioactive oral mucositis, visual analogue scale （VAS） pain score, serum levels of CRP, TGF-β1, IL-6 and T lymphocyte subsets were statistically compared between two groups by independent-sample t-test. Results At 4 and 6 weeks after corresponding treatment, the incidence of grade Ⅱ and Ⅲ oral mucositis in the experimental group was significantly lower than that in the control group （P=0.018,0.021,0.027,0.014））. In the experimental group, the incidence of moderate and severe pain assessed by VAS was significantly lower compared with that in the control group （P=0.019,0.025）;After corresponding treatment, the CRP levels in both groups were down-regulated and the CRP level in the experimental group was considerably lower than that in the control group （P=0.013）. The levels of TGF-β1 and IL-6 in the control group were significantly increased （P=0.015、0.021）, whereas dramatically declined in the experimental group （P=0.012,0.019）. CD3（＋）,CD4（＋）,CD8（＋） and CD4（＋）/CD8（＋） were remarkably elevated in two groups, and more significant increase was observed in the experimental group （P=0.024,0.036,0.029,0.017）. Conclusions Oral ulcer protective agent can effectively inhibit the progression of oral mucosal injury, shorten the healing time and relieve the pain of oral mucosal injury in patients with NPC., which is worthy of clinical application.

关 键 词：口腔溃疡防护剂 口腔黏膜 炎性因子 鼻咽肿瘤/放射疗法 

分 类 号：R730.55[医药卫生—肿瘤] R739.63[医药卫生—临床医学]