滋阴清热法防治阴虚内热证急性放射性口腔炎临床研究

目的观察滋阴清热法防治鼻咽癌患者急性放射性口腔炎属阴虚内热证的效果。方法将60例确诊为鼻咽癌并进行首次放疗的患者,分为两组:治疗组(31例)采用滋阴清热法治疗方案,对照组(29例)采用西医治疗方案。观察治疗期间口腔黏膜情况,检测唾液中表皮生长因子(epidermal growth factor,EGF)的含量,并利用欧洲癌症研究与治疗组织(European Organization for Researeh and Treatment of Cancer,EORTC)的生活质量核心量表QLQ-C30(quality of life questionnaire-core 30)评价患者的生活质量。结果所有患者在放疗中均出现放射性口腔黏膜反应,治疗组的反应轻于对照组(P0.01)。随着放疗剂量的增加,两组唾液中EGF的含量呈下降趋势,在放疗至40 Gy时下降明显(P0.01),至70 Gy时降到最低值(P0.01),治疗组下降程度均较对照组轻,差异有统计学意义(P0.01)。两组患者放疗后QLQ-C30生活质量比较显示:治疗组患者的生活质量总健康状况要优于对照组,两组比较差异有统计学意义(P0.01)。结论滋阴清热法可推迟放射性口腔炎出现的时间,减轻放疗反应,能改善患者总体生活质量,对防治急性放射性口腔黏膜炎有较好的疗效,具有一定的临床推广应用价值。

Clinical Study on Treatment of Acute Radiation Oral Mucositis of Yin Deficiency-Induced Inner Heat Syndrome by Nourishing Yin and Clearing Heat Method

Objective To observe the clinical effect of Chinese medicine for nourishing yin and clearing heat therapy （CM therapy） in treating nasopharyngeal carcinoma （NPC） patients with yin deficiency-induced inner heat syndrome, and suffered from acute radiation oral mucositis. Methods Sixty patients with NPC fitting to the inclusion criteria and undergoing initial dose radiotherapy were assigned to two groups. The 31 patients in the treatment group received CM therapy, and the 29 in the control group were treated with standard Western medical therapy. The condition of oral mucosa and epidermal growth factor （EGF） content in saliva of patients during the therapeutic period were observed, meanwhile the quality of life （QOL） of patients was estimated with the quality of life questionnaire-core 30 （QLQ-C30） issued by European Organization for Researeh and Treatment of Cancer （EORTC）. Results Acute radiation oral mucositis occurred in all patients, but the severity in the treatment group was milder than that in the control group（P 〈0.01 ）. Salivary EGF content decreased along with the increasing radiation dosage, it decreased significantly when 40 Gy radiated and down to the minimum when 70 Gy radiated, but the decrement in the treatment group was less than that in the control group （P〈0.01）. Comparison of QOL by QLQ-C30 scale showed that after radiotherapy the global health status in the treatment group was superior to the control group （ P 〈 0.01 ）. Conclusion Chinese medicine for nourishing yin and clearing heat therapy could actually postpone the occurrence of acute radiation oral mucositis, lessen the adverse reaction of radiotherapy and improve patient＇s QOL, show a favorable effect in prevention and treatment, and has definite application value for clinical spreading.