龙胆泻肝丸干预防治放射性分泌性中耳炎的临床研究

发布时间：2018-03-02 14:25

本文选题：鼻咽癌　切入点：放射疗法　出处：《南华大学》2012年硕士论文　论文类型：学位论文

【摘要】：目的本课题拟对120例鼻咽癌（NPC）的患者在放疗过程中及放疗后分时段服用龙胆泻肝丸或安慰剂，并在放疗不同时间点进行主观症状评价、电耳镜、纯音听阈测试、声导抗动态检测及咽鼓管功能检查，将放疗前、放疗剂量分别达20Gy、30Gy、50Gy时、以及放疗结束时、结束后3个月、结束后6个月共7个不同时间点的各组相关数据进行统计分析，可以对放射性分泌性中耳炎（RSOM）在整个观察期内的发病率及NPC患者的中耳积分值进行动态观察，探讨RSOM发生规律及中耳积分值的变化规律，并总结出龙胆泻肝丸对RSOM及中耳积分值的干预疗效；并将在放疗开始到放疗结束后6个月确诊的RSOM患者纳入治疗阶段，于放疗结束后6个月时将龙胆泻肝丸对RSOM的临床控制疗效进行统计分析，并总结出龙胆泻肝丸对RSOM的治疗效果。方法随机抽取符合标准的120例NPC放疗患者，进行分组对照实验。实验组包括90名接受放疗患者：第一组30名，从放疗开始时服用安慰剂干预防治，剂量达20Gy到放疗结束后6个月均服用龙胆泻肝丸干预防治。第二组30名，从放疗开始时服用安慰剂干预防治，剂量达30Gy到放疗结束后6个月均服用龙胆泻肝丸干预防治。第三组30名，从放疗开始时服用安慰剂干预防治，剂量达50Gy到放疗结束后6个月均服用龙胆泻肝丸干预防治。对照组包括接受放疗的30名患者，从放疗开始到放疗结束后6个月均服用安慰剂干预防治。结果 1、NPC患者在整个观察期内，出现RSOM的最早时间点为放疗剂量达30Gy时，而最明显的时间点为放疗结束后3个月和6个月时，RSOM的发生不随着放疗的结束而终止。 2、随着放疗时间的推移，NPC患者在整个观察期内中耳积分值呈逐渐下降趋势。本课题在（放疗开始时到放疗剂量达20Gy）及（放疗剂量达30Gy到放疗结束后3个月）这两个时间点中耳积分值下降趋势最明显，实验组在放疗结束后3个月中耳积分值呈现缓慢上升趋势，而对照组在整个观察期内积分值均呈现进行性下降。 3、经计数资料X2检验，实验组与对照组在干预与防治RSOM疗效方面比较存在显著性差异(p0.05)；经Mann-Whitney U非参数秩和检验，实验组与对照组在干预NPC患者中耳积分值方面存在显著性差异(Sig0.05)。结论 1、各组出现RSOM的最早时间点为放疗剂量达30Gy时，放疗结束后3个月和放疗结束后6个月是RSOM的高发期，并且RSOM的发生并不随着放疗的结束而终止。如能尽早进行干预，可降低RSOM的发病率，改善NPC患者的中耳功能，提高其生活质量。 2、龙胆泻肝丸能明显降低NPC患者在整个观察期内RSOM的发病率，，并对RSOM的临床控制率明显优于对照组。 3、NPC患者中耳积分值在放疗开始到放疗剂量达20Gy及放疗剂量达30Gy到放疗结束后3个月这两个阶段下降趋势最明显。龙胆泻肝丸能明显干预NPC患者在整个观察期内中耳积分值变化，改善其中耳功能。
[Abstract]:Purpose. In this study, 120 patients with nasopharyngeal carcinoma (NPC) were treated with Gentian Xiegan pill or placebo during and after radiotherapy, and subjective symptom evaluation, audioscope, pure tone audiometry test were performed at different time points after radiotherapy. Dynamic detection of acoustic conductance and eustachian tube function test were conducted. The relevant data of 7 different time points were statistically analyzed before radiotherapy, when the radiation dose reached 20 Gy / 30 Gy / L 50Gy, 3 months after radiotherapy, 3 months after radiotherapy and 6 months after radiotherapy, respectively. The incidence of radioactive secretory otitis media (RSOM) during the whole observation period and the middle ear integral value of NPC patients can be observed dynamically, and the regularity of RSOM occurrence and the change of middle ear integral value can be discussed. The intervention effect of Longdan Xiegan pills on RSOM and middle ear integral value was summarized, and the RSOM patients diagnosed from the beginning of radiotherapy to the end of radiotherapy 6 months after radiotherapy were included in the treatment stage. The clinical control effect of Longdan Xiegan Pill on RSOM was statistically analyzed 6 months after radiotherapy, and the therapeutic effect of Longdan Xiegan Pill on RSOM was summarized. Method. One hundred and twenty patients with NPC were randomly selected and divided into two groups. The experimental group included 90 patients receiving radiotherapy:. The first group of 30 patients were treated with placebo from the beginning of radiotherapy. The dose of 20 Gy was 20 Gy and the treatment was treated with Longdan Xiegan pill 6 months after radiotherapy. In the second group, 30 patients were treated with placebo from the beginning of radiotherapy. The dose of 30 Gy was 30 Gy and the treatment was treated with Longdan Xiegan pill 6 months after radiotherapy. 30 patients in the third group were treated with placebo from the beginning of radiotherapy. The control group consisted of 30 patients who received radiotherapy and were treated with placebo from the beginning of radiotherapy to 6 months after radiotherapy. Results. 1 during the whole observation period, the earliest time point for the occurrence of RSOM was when the radiation dose was 30 Gy, and the most obvious time point was 3 months and 6 months after radiotherapy, and the occurrence of RSOM did not end with the end of radiotherapy. 2, with the time of radiotherapy, the integral value of middle ear in NPC patients showed a decreasing trend during the whole observation period. In this study, the two items were: (from the beginning of radiotherapy to the dose of 20 Gy) and from 30 Gy to 3 months after radiotherapy. The decreasing trend of the middle ear integral value is the most obvious at the time point, In the experimental group, the middle ear integral showed a slow upward trend 3 months after radiotherapy, while the control group showed a progressive decline in the whole observation period. 3After X2 test, there was a significant difference between the experimental group and the control group in the effect of intervention and prevention of RSOM, and by Mann-Whitney U non-parametric rank sum test, there was a significant difference between the experimental group and the control group in the intervention of middle ear integral value of NPC patients. Conclusion. 1. The earliest time point for the occurrence of RSOM in each group was when the radiation dose was 30 Gy, 3 months after the end of radiotherapy and 6 months after the end of radiotherapy, and the incidence of RSOM did not end with the end of radiotherapy. It can reduce the incidence of RSOM, improve the middle ear function of NPC patients and improve their quality of life. 2. Longdan Xiegan pills could significantly reduce the incidence of RSOM in patients with NPC during the whole observation period, and the clinical control rate of RSOM was significantly better than that of the control group. 3The decrease trend of middle ear integral value in patients with NPC was most obvious between the beginning of radiotherapy and radiotherapy dose of 20 Gy and radiotherapy dose of 30 Gy to 3 months after radiotherapy. Longdan Xiegan pill could significantly interfere with the change of middle ear integral value in patients with NPC during the whole observation period. Improve the function of the middle ear.
【学位授予单位】：南华大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R818;R739.63

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