川云冰块预防鼻咽癌放射治疗口腔黏膜损伤临床观察  

Clinical observation of Chuan Yun Ice on prevention of oral mucosal damage in nasopharyngeal carcinoma radiotherapy

作　　者：靳昭芳[1] 韩俊庆[1] 孟祥文[1] 孙迎红[1] 戴洪海[1] JIN Zhao-fang;HAN Jun-qing;MENG Xiang-wen;SUN Ying-hong;DAI Hong-hai(Department of Oncology,Shandong Provincial Hospital Affiliated to Shandong University,Jinan 250021,P.R.China)

机构地区：[1]山东大学附属省立医院肿瘤中心,山东济南250021

出　　处：《中华肿瘤防治杂志》2019年第8期584-587,共4页Chinese Journal of Cancer Prevention and Treatment

基　　金：济南市临床医学创新计划(201506003);全国重点专科资助项目(HL201402)

摘　　要：目的目前临床上防治放射性口腔黏膜损伤方法效果不明显,多种不同方法用于临床以提高其疗效。本研究旨在探讨川贝枇杷膏和云南白药冰块(川云冰块)在鼻咽癌放射治疗后防治口腔黏膜损伤的疗效及安全性。方法选取2016-01-20-2018-04-12山东大学附属省立医院接受鼻咽癌放射治疗的100例患者为研究对象,分为观察组和常规组,各50例。常规组给予放射治疗的常规护理,观察组在此基础上给予川贝枇杷膏和云南白药冰块含服。回顾分析2组患者放射治疗后口腔黏膜放射性炎症程度、黏膜疼痛程度、口腔咽拭子培养有细菌率及体质量降低率情况。结果放射治疗第4周,2组患者口腔咽拭子培养有细菌率(χ~2=0.542,P=0.461)和体质量降低率(χ~2=1.000,P=0.317)比较,差异均无统计学意义。放射治疗第8周,观察组及常规组Ⅲ、Ⅳ级口腔黏膜炎发生率分别为6%(3/50)、0(0/50)和32%(16/50)、18%(9/50),Z=-5.123,P<0.001;观察组及常规组口腔黏膜Ⅱ、Ⅲ度疼痛发生率分别为50%(25/50)、6%(3/50)和60%(30/50)、22%(11/50),Z=-3.078,P=0.002;观察组及常规组口腔咽拭子培养有细菌率分别为32%(16/50)和64%(32/50),χ~2=10.256,P=0.001;观察组及常规组体质量降低率分别为34%(17/50)和70%(35/50),χ~2=12.981,P=0.001,差异均有统计学意义。结论川云冰块能缓解鼻咽癌患者的放射性口腔黏膜炎症反应,减轻放射性黏膜疼痛,减少口腔细菌感染,从而改善营养状态。OBJECTIVE Currently,the effect on prevention and treatment of oral mucosal damage after radiotherapy in nasopharyngeal carcinoma(NPC)remains poor.Different methods have been applied to increase the efficacy.This study reported the use of Nin Jiom Pei Pa Koa and Yun Nan Bai Yao Ice(for short Chuan Yun Ice,same as below)in the prevention and treatment of oral mucosal damage after NPC radiotherapy,and evaluated the efficacy and safety of using Chuan Yun Ice in prevention and treatment of patients with oral mucosal damage.METHODS Totally 100 patients with oral mucosal damage after NPC radiotherapy in Department of Oncology of Shandong Provincial Hospital Affiliated to Shandong University were selected from 2016-01-20 to 2018-04-12,and were randomly divided into the experimental group(50 cases)and the control group(50 cases).The patients in control group were given routine care of radiotherapy.The experimental group was Chuan Yun Ice in a convenient sublingual form.The degree of oral mucositis after NPC radiotherapy,mucosal pain,the bacterial rate in oral swab cultivation and body mass index loss rate were reviewed and analyzed between two groups.RESULTS After 4 weeks of radiotherapy,there were no significant differences of the bacterial rate in oral swab cultivation(χ^2=0.542,P=0.461)and body mass index loss rate(χ^2=1.000,P=0.317)between the two groups.After 8 weeks of radiotherapy,the degree of oral mucositis at stageⅢandⅣwere 6%(3/50),0 in control group and 32%(16/50),18%(9/50)in experimental group(Z=-5.123,P<0.001).The patients who were observedⅡ-grade pain andⅢ-grade pain were 50%(25/50),6%(3/50)in treatment group and 60%(30/50),22%(11/50)in control group(Z=-3.078,P=0.002).The bacterial rates in coral swab cultivation were 32%(16/50)and 64%(32/50)respectively(χ^2=10.256,P=0.001);body mass index loss rate in the two groups were 34%(17/50)and 70%(35/50),respectively(χ^2=12.981,P=0.001),and there was significantly difference between the two groups(P<0.05).CONCLUSION Chuan Yun Ice can relieve the radiati

关 键 词：鼻咽癌 放射治疗 口腔黏膜损伤 川贝枇杷膏 云南白药冰块 

分 类 号：R739.63[医药卫生—肿瘤]