自拟养阴清热解毒方治疗急性放射性口腔炎的疗效观察  

Clinical Effect of Self-designed Yangyin Qingre Jiedu Recipeon Acute Radiation-induced Oral Mucositis

作　　者：刘书晓 吴昊 李珊 高红丽 周晓阳 LIU Shu-xiao;WU Hao;LI Shan;GAO Hong-li;ZHOU Xiao-yang(Department of Traditional Chinese Medicine,Second Affiliated Hospital of Air Force Military Medical University,Xi'an Shaanxi 710038)

机构地区：[1]中国人民解放军空军军医大学第二附属医院中医科,陕西西安710038

出　　处：《世界中西医结合杂志》2022年第7期1468-1471,共4页World Journal of Integrated Traditional and Western Medicine

基　　金：陕西省中医药管理局项目(15JC017)。

摘　　要：目的探讨自拟养阴清热解毒方治疗阴虚毒热型急性放射性口腔黏膜炎(Radiotherapy-Induced Oral Mucositis,RIOM)的疗效观察。方法选取2019年1月—2019年12月期间于中国人民解放军空军军医大学第二附属医院住院的鼻咽癌患者60例作为研究对象,根据随机原则将其分为治疗组和对照组,每组各30例。所有患者均行放射治疗,对照组予以庆大霉素注射液4 ml+维生素B12注射液1 ml+地塞米松注射液2 ml+利多卡因注射液5 ml漱口液漱口,治疗组在对照组基础上予以自拟养阴清热解毒方。治疗9周后,观察比较两组患者急性RIOM的发生情况及程度差异、临床疗效、中医症状评分及炎性因子[γ-干扰素(Interferon-γ,IFN-γ)、肿瘤坏死因子-α(Tumor necrosis factor-α,TNF-α)及白细胞介素-6(Interleukin-6,IL-6)]的变化情况。结果治疗过程中两组患者均出现不同程度的RIOM,其中治疗组Ⅲ~Ⅳ级RIOM的发病率为36.67%(11/30),优于对照组53.33%(16/30),差异有统计学意义(P<0.05)。治疗后治疗组总有效率为86.67%(26/30)优于对照组73.33%(22/30),差异有统计学意义(P<0.05)。治疗后两组患者中医症状评分较治疗前降低,差异有统计学意义(P<0.05);且治疗组下降程度优于对照组,差异有统计学意义(P<0.05)。治疗后两组患者IFN-γ、TNF-α、IL-6水平较治疗前降低,差异有统计学意义(P<0.05);且治疗组下降程度优于对照组,差异有统计学意义(P<0.05)。结论自拟养阴清热解毒方能有效减低阴虚毒热型急性RIOM的发生率及发生程度,降低炎性因子水平,减轻患者炎性反应,提高临床疗效。Objective To investigate the clinical efficacy of self-designed Yangyin Qingre Jiedu Recipeon(YQJR)acute radiation-induced oral mucositis(RIOM)of yin deficiency with toxin-heat syndrome.Methods A total of 60 cases with nasopharyngeal carcinoma who were treated by radiotherapyin the Second Affiliated Hospital ofAir Force Military Medical University from January to December 2019 were randomizedinto the observation group(n=30)and the control group(n=30).The control group was given gargle and Gentamicin Injection 4 ml+Vitamin B12 Injection 1 ml+Dexamethasone Injection 2 ml+Lidocaine Injection 5 ml.In addition to the therapy in the control group,YQJR was applied in the observation group.Thetreatment lasted 9 weeks for both groups.The occurrence and degree of acute RIOM,clinical efficacy,traditional Chinese medicine(TCM)syndrome score,and inflammatory factors[tumor necrosis factor(TNF-α),interferon(IFN-γ),and interleukin-6(IL-6)]were compared between the two groups.Results(1)RIOM of different grades occurred in both groups.The incidence of grade III-IV acute RIOM in the observation group was 36.67%(11/30),as compared with the 53.33%(16/30)in the control group(P<0.05).(2)The total effective ratewas 86.67%(26/30)in the observation group,higher than the 73.33%(22/30)in the control group(P<0.05).(3)The TCM syndrome score was lower than that before treatment in both groups(P<0.05),and lower in the observation group than in the control group(P<0.05).(4)After treatment,the levels of IFN-γ,TNF-α,and IL-6 in the two groups were lower than those before treatment(P<0.05),and the decrease was larger in the observation group than in the control group(P<0.05).Conclusion YQJR can effectively reduce the incidence and degree of acute RIOM of yin deficiency with toxin-heat syndrome,decrease the level of inflammatory factors,alleviate inflammatory reaction,and improve the clinical efficacy.

关 键 词：养阴清热解毒方 放射性口腔黏膜炎 鼻咽癌 阴虚毒热证 

分 类 号：R781.5[医药卫生—口腔医学]