生津活血中药在头颈部放疗中对涎腺功能影响的研究

目的探讨生津活血中药在头颈部肿瘤患者放疗过程中对涎腺功能的影响。方法将38例首程放疗的患者随机分为实验组(中药加放疗)18例和对照组(单纯放疗)20例。对放疗前及放疗不同剂量时的口干程度、pH值、唾液流率及淀粉酶浓度进行比较。结果随放疗剂量的增加,2组患者口干程度增加,唾液流率与淀粉酶浓度均降低。在放疗至20、40 Gy时实验组的唾液流率和淀粉酶浓度均较对照组高。但在达到60 Gy时,2组数据则趋于接近。另外,患者的主观口干程度与客观的唾液流率下降程度之间并不直接对应。结论①头颈部肿瘤患者在放疗过程中辅以生津活血中药,可在一定程度上改善口干症状,但并不足以预防放射性口干症的发生。②患者的口干严重程度和唾液流率下降程度之间并不严格对应,患者主观的口干程度并不能作为反映唾液腺功能受损程度的可靠指标。

Study on Chinese herbal medicine for salivary glands in radiotherapy of patients with head and neck cancer

Objective To observe the effects of Chinese herbal medicine on salivary glands in patients with head and neck cancer during radiotherapy （ RT ）. Methods Thirty-eight cases with head and neck cancer were randomly divided into observation group treated with RT plus Chinese herbal medicine and control group treated with RT alone. The level of mouth dryness, pH value, the flow rate and the salivary amylase concentration of saliva were measured before and during the RT. Results The severity of mouth dryness deteriorated during RT. As the RT dose increased, the flow rate, pH value and salivary amylase decreased in both groups. At 20 and 40 Gy , the flow rate and salivary amylase concentration of the observation group were significantly higher than those of the control group. But when the RT dose arrived at 50 or 60 Gy, the data from the two groups tended to be close to each other. Besides,there was not no- ticeable interrelation between the dryness of patients and the salivary flow rate. Conclusion Chinese herbal medicine used in the study was effective to relieve the severity of dryness during RT to some degree. But it was not enough to prevent the xerostomia. In addition, the subjective dry mouth aesthesis of patients was not a reliable indicator of the level of lesion to salivary glands.