血府逐瘀汤防治鼻咽癌患者急性放射性口腔黏膜炎的临床疗效观察  

Clinical Observation of Xuefu Zhuyu Decoction in Treatment of Acute Radiation Oral Mucositis in Patients with Nasopharyngeal Carcinoma

作　　者：赵悦欣 鹿红[2] 刘婕 王逸君[2] 陈乐君 林洋 宋威[2] 于大海[2] ZHAO Yuexin;LU Hong;LIU Jie;WANG Yijun;CHEN Lejun;LIN Yang;SONG Wei;YU Dahai(Nanjing University of Chinese Medicine,Nanjing 210023,China;Jiangsu Provincial Hospital of Chinese Medicine Affiliated to Nanjing University of Chinese Medicine,Nanjing 210029,China)

机构地区：[1]南京中医药大学,江苏南京210023 [2]南京中医药大学附属江苏省中医院,江苏南京210029

出　　处：《中医药信息》2023年第2期70-74,共5页Information on Traditional Chinese Medicine

基　　金：江苏省中医药科技发展计划项目(YB2020009);江苏省研究生科研创新计划项目(KYCX22_1914)。

摘　　要：目的:观察血府逐瘀汤对鼻咽癌患者急性放射性口腔黏膜炎(RTOM)的防治疗效。方法:选择就诊于南京中医药大学附属江苏省中医院符合纳入标准的局限期(T_(0~4)N_(0~3)M_(0))鼻咽鳞癌患者47例,依据随机数字表随机分为治疗组24例和对照组23例。治疗组放疗开始即服用血府逐瘀汤,必要时予西药对症治疗;对照组出现急性RTOM症状时予西药对症治疗,两组均治疗至放化疗结束。比较两组患者鼻咽癌治疗效果、放射性口腔黏膜炎分级情况、血流变与凝血相关指标以及吞咽疼痛、口干口渴、烧灼感、便干便秘中医症状积分变化情况。结果:近期疗效比较,治疗组总有效率为95.84%(23/24),高于对照组91.30%(21/23),但差异无统计学意义(P>0.05)。RTOM分级情况比较,治疗组Ⅲ度以上口腔黏膜炎发生率较对照组明显降低,差异具有统计学意义(P<0.05)。治疗后,两组血流变指标均降低,且治疗组优于对照组(P<0.01);治疗组FIB和D-D均较治疗前降低(P<0.01),且优于对照组(P<0.05,P<0.01);放疗后1个月,治疗组中医症状积分较对照组降低,差异具有统计学意义(P<0.05,P<0.01)。结论:血府逐瘀汤能显著降低鼻咽癌患者急性RTOMⅢ度以上发生率,改善患者治疗后相关中医临床症状,提高鼻咽癌患者治疗疗效并降低血流变和凝血指标,且无明显不良反应。Objective:To observe the clinical effect of Xuefu Zhuyu Decoction on radiotherapy-induced oral mucositis(RTOM)in prevention and treatment of nasopharyngeal carcinoma.Methods:47 patients with nasopharyngeal squamous cell carcinoma in limited stage T_(0~4)N_(0~3)M_(0)were randomly divided into the treatment group(n=24)and the control group(n=23).The control group was treated with western medication for acute RTOM;on which basis,the treatment group was also treated with Xuefu Zhuyu Decoction.Clinical effect,grade of radiation oral mucositis,hemorheology-related indexes,coagulation-related indexes,and TCM syndromes score,including swallowing pain,dry mouth,thirsty,burning feeling and constipation,were compared between the two groups.Results:In terms of short-term efficacy evaluation,the total effective rate of the treatment group was 95.84%(23/24),which was higher than 91.30%(21/23)of the control group,but in which there was no statistical difference between the two groups(P>0.05).In terms of RTOM grade,the incidence of oral mucositis above grade Ⅲ was significantly lower in the treatment group than that in the control group(P<0.05).The indexes of hematological rheology and coagulation were lower after the treatment than those before the treatment in the two groups,of which the treatment group was better than the control group(P<0.01).FIB and D-D were lower after the treatment than those before the treatment in the treatment group,of which the treatment group was superior to the control group(P<0.05,P<0.01).TCM symptoms score was lower in the treatment group than that in the control group after one month of radiotherapy(P<0.05,P<0.01).Conclusion:Xuefu Zhuyu Decoction can significantly reduce the incidence of acute RTOM above grade Ⅲ in patients with nasopharyngeal carcinoma,improve the hemorheology-related indexes and coagulation-related indexes,but without obvious adverse reactions.

关 键 词：血府逐瘀汤 鼻咽癌 放射治疗 放射性口腔黏膜炎 临床疗效 

分 类 号：R273[医药卫生—中西医结合]