加味养阴清肺汤防治急性放射性口腔炎的临床观察

目的:探讨加味养阴清肺汤防治急性放射性口腔炎的疗效和对唾液中表皮生长因子EGF的影响。方法:将80例鼻咽癌行根治性放疗的患者随机分为两组,每组40例,治疗组每天含服中药加味养阴清肺汤,对照组从放疗剂量达20Gy后每天含漱西药漱口水。观察两组病例放射性口腔炎发生率,用ELISA法检测唾液中EGF。结果:随着放疗剂量增加,两组患者Ⅲ、Ⅳ度口腔黏膜反应的发生率显著增加(均P<0.05)。但治疗组患者Ⅲ、Ⅳ度口腔黏膜反应的发生率始终低于对照组(均P<0.05)。放疗前两组唾液EGF含量无显著性差异(P=0.879),随着放疗剂量的增加,两组唾液EGF含量呈下降趋势,有显著的统计学意义(均P=0.000)。治疗组下降程度均较对照组轻,差异有显著意义(均P<0.05)。结论:加味养阴清肺汤对急性放射性口腔黏膜炎的预防性治疗效果显著,其作用机制可能是通过提高唾液EGF水平,促进口腔黏膜组织的增生与修复。

Clinical Observation on Treatment of Acute Radiation-Induced Stomatitis by Modified Yangyin Qingfei Decoction

Objective:To explore the effect of Modified Yangyin Qingfei Decoction on treatment outcome and the levels of epidermal growth factor(EGF)in saliva for acute radiation-induced stomatitis.Methods:80 cases with a radical radiotherapy were divided into 2 groups randomly,40 cases in the treatment group and 40 cases in the control group.The treatment group was treated by Modified Yangyin Qingfei Decoction after the initiation of radiotherapy.The control group was treated by the regular western medicine mouthwash after DT=20Gy.The incidence rates of stomatitis and the levels of EGF in saliva were measured.Results:As the increasing dose of radiotherapy,the incidence rates of III-degree and IV-degree stomatitis were increased significantly in the two groups(P<0.05).However,the incidence rate of treatment group was lower than that of control group(P<0.05).The levels of EGF in two groups showed no differences before the initiation of radiotherapy(P=0.879).As the increasing dose of radiotherapy,the levels of EGF in two groups were remarkably reduced(P=0.000).The levels of EGF of treatment group was higher than those in control group after radiotherapy(P<0.05).Conclusion:The acute radiation-induced stomatitis was significantly improved after prophylactic therapy of Modified Yangyin Qingfei Decoction.The mechanism of this therapy might prevent a decrease in the levels of EGF in saliva induced by acute radiation to promote hyperplasia and repair of oral mucosa.