炙甘草汤防治鼻咽癌放疗后气阴两虚型口干症疗效观察及分析

目的:观察炙甘草汤防治鼻咽癌患者放疗后口干症的效果,并分析其可能机制。方法:将同期收治的100例鼻咽癌患者按照随机数字表法分为治疗组和对照组各50例。两组均予调强放疗30次,在此基础上治疗组予炙甘草汤含嗽5 min再咽下,对照组予安慰汤(颜色、气味与炙甘草汤相似)含嗽5 min再咽下。治疗时间均为放疗开始到放疗结束后6个月。放疗结束及结束后6个月分别对两组进行口干程度可视分析标尺法(VAS)评分,检测唾液腺分泌指数(EF)及血清白细胞介素(IL)-17、IL-10水平,同时记录不良反应发生情况。结果:放疗结束及结束后6个月,治疗组VAS评分均低于对照组,EF均高于对照组,血清IL-17水平均低于对照组,血清IL-10水平均高于对照组,组间比较差异有统计学意义(P0.05)。治疗期间两组均未出现严重不良反应。结论:炙甘草汤对防治鼻咽癌患者放疗后口干症效果确切,且无明显不良反应,其机制可能与修复患者受损的唾液腺、提高机体免疫功能有关。

Observation and Analysis on Therapeutic Effects of Zhigancao Decoction in Prevention and Treatment of Xerostomia of Qi and Yin Deficiency Type after Radiotherapy of Nasopharyngeal Carcinoma

Objective:To observe the therapeutic effects of Zhigancao Decoction in the prevention and treatment of xerostomia after radiotherapy of nasopharyngeal carcinoma and analyze the possible mechanism.Methods:A total of 100 patients with nasopharyngeal carcinoma were divided into the treatment group and the control group according to random number table,with 50 patients in each group. Both groups were treated with IMRT,meanwhile,the treatment group was given Zhigancao Decoction by keeping in mouth for 5 minutes and swallowing slowly,the control group were given placebo decoction with similar color and smell by the same administration.The course of treatment lasted from the beginning of radiotherapy to 6 months after the ending of radiotherapy. At the end of the radiotherapy and 6 months after the end of the radiotherapy,the visual simulation score(VAS) of xerostomia were measured,and the salivary gland secretion index(EF) and serum interleukin(IL)-17 and IL-10 levels were measured and the adverse reactions were recorded during the treatment in the 2 groups. Results:One patient in the treatment group and two patients in the control group withdrew from the study due to poor compliance. At the end of the radiotherapy and 6 months after the end of the radiotherapy,the VAS of the treatment group were significantly lower than those in the control group,and the EF in the treatment group was significantly higher than that in the control group. The serum IL-17 level was significantly lower than that of the control group,and the serum IL-10 level was significantly higher than that of the control group. There were statistical significance between the two groups(P< 0.05). No serious adverse reactions occurred in both groups during the treatment period. Conclusions:Zhigancao Decoction was effective in preventing and treating xerostomia in patients with nasopharyngeal carcinoma after radiotherapy,and there were no obvious adverse reactions. The mechanism might be concerned with repairing damaged salivary glands and improving immune function.