凉营清气汤治疗鼻咽癌放疗后急性放射性口腔黏膜炎的临床研究  

Effect of Liangyingqingqi Decoction in Treating the Acute Radiotherapy-induced Oral Mucositis of Nasopharyngeal Carcinoma after Radiotherapy

作　　者：程玲 宋璟 王桦 苏旭春 黄赖机 贺颖 戴诗蕾 孔嘉欣 CHENG ling;SONG Jing;WANG Hua;SU Xuchun;HUANG Laiji;HE Ying;DAI Shilei;KONG Jiaxin(Departmentof Traditional Chinese Medicine,Affiliated Tumor Hospital of Guangzhou Medical University,Guangzhou 510000,China;Departmentof Radiotherapy,Affiliated Tumor Hospital of Guangzhou Medical University,Guangzhou 510000,China)

机构地区：[1]广州医科大学附属肿瘤医院中医科,广东广州510000 [2]广州医科大学附属肿瘤医院放疗科,广东广州510000

出　　处：《中国民族民间医药》2023年第7期99-103,共5页Chinese Journal of Ethnomedicine and Ethnopharmacy

基　　金：广东省中医药管理局科研项目(No.20212138)。

摘　　要：目的:研究凉营清气汤治疗鼻咽癌放疗后急性放射性口腔黏膜炎(RTOM)的作用。方法:选取符合鼻咽癌放疗后急性RTOM患者60例,采用随机数字表分为观察组和对照组各30例。两组均予调强放射治疗及生理盐水口腔护理。对照组予康复新液含服;观察组予凉营清气汤含服。两组均连续治疗7周。观察两组治疗后临床表现改善情况与口腔黏膜恢复所需时间,采用视觉模拟疼痛评分(VAS)与中医证候评分(TCMSCS)进行评价。酶联免疫法检测两组放疗前、治疗前后患者血清白介素IL-6、IL-8及肿瘤坏死因子TNF-α水平。结果:观察组总有效率为93.33%,高于对照组(73.33%),差异有统计学意义(P<0.05)。治疗后,观察组口腔黏膜恢复所需时间为(2.30±1.09)d,少于对照组的(3.23±1.48)d,差异有统计学意义(P<0.05)。观察组治疗后TCMSCS及VAS均明显低于对照组,差异有统计学意义(P<0.05)。治疗前两组患者血清IL-6、IL-8和TNF-α水平均高于放疗前,差异有统计学意义(P<0.05)。观察组治疗后血清IL-6、IL-8和TNF-α水平均低于对照组,差异有统计学意义(P<0.05)。结论:凉营清气汤可有效改善鼻咽癌放疗后RTOM的临床表现,不仅缩短口腔黏膜恢复时间,还可有效缓解口腔疼痛,其作用可能与抑制IL-6、IL-8与TNF-α有关。Objective To study the effect of Liangyingqingqi decoction in treating the acute radiotherapy-induced oral mucositis(RTOM)of nasopharyngeal carcinoma after radiotherapy.Methods 60 nasopharyngeal carcinoma patients diagnosed with acute RTOM after radiotherapy were divided into observation and control group,and there were 30 patients in each one.All patients were given the conventional oral care and intensity modulated radiation therapy.The control group was treated with Kangfuxin solution while the observation group were given the Liangyingqingqi decoction.And they were treated with 7 weeks.The improvement of manifestations and the time for recovery of oral mucosa were observed and evaluated by visual analogue scale(VAS)and traditional Chinese medicine symptom complex score(TCMSCS).The serum concentrations of interleukin IL-6,IL-8 and tumor necrosis factor TNF-αbefore radiotherapy,before and after medication were tested by enzyme-linked immune-sorbent assay.Results The total effective rate of observation group(93.33%)was higher than the control group(73.33%),and there was the difference(P<0.05).After treatment,the TCMSCS and VAS of observation group were obviously lower than the control group,and there were the differences(P<0.05).Moreover,the serum concentrations of IL-6,IL-8 and TNF-αof both groups before medication were higher than those before radiotherapy,and there were the differences(P<0.05).And the serum concentrations of IL-6,IL-8 and TNF-αof observation group were lower than the control group,and there were the differences(P<0.05).Conclusion Liangyingqingqi decoction could improve the clinical features of RTOM of nasopharyngeal carcinoma.Not only could it decrease the recovery time of month mucosa,but also it could relieve the pain.And its mechanism could be related to inhabit the IL-6,IL-8 and TNF-α.

关 键 词：凉营清气汤 口疮 鼻咽癌 调强放疗 放射性口腔黏膜炎 

分 类 号：R273[医药卫生—中西医结合]