清热解毒益气养阴法防治鼻咽癌放疗后副反应近期疗效的临床观察
发布时间：2018-08-11 16:47
【摘要】：目的:观察清热解毒益气养阴法防治鼻咽癌放疗近期副反应的临床疗效,对比治疗组与观察组的相关数据,评估清热解毒益气养阴法在防治鼻咽癌放疗近期副反应方面的临床价值。方法:采用随机对照临床研究的方法,纳入50例初次放射治疗的鼻咽癌患者,随机分为治疗组和对照组,每组分别为25例,治疗组放疗期间加用清热解毒益气养阴中药治疗。比较两组在KPS评分、急性放射性口咽粘膜损伤分级及出现时间、急性放射性皮肤反应分级及出现时间、急性放射性唾液腺损伤分级、放疗后生存质量方面的差异,并评价试验药物相关不良反应。结果:在急性放射性口咽粘膜损伤分级及出现时间方面,治疗组出现1级与2级急性口咽粘膜反应的时间与对照组相比较,差别不具有统计学意义(P0.05);治疗组在3级急性口咽粘膜反应发生率上明显低于对照组,差别具有统计学意义(P0.05);提示在减少严重急性放射性口咽粘膜反应方面,治疗组具有明显优势。在急性放射性皮肤反应分级及出现时间方面,治疗组出现1级急性放射性皮肤反应的平均时间比对照组晚,差异具有统计学意义(P0.05);在发生2级急性放射性皮肤反应发生率方面,治疗组比观察组低,差异具有统计学意义(P0.05);治疗组出现3级急性放射性皮肤反应发生率与对照组相比较,差别无统计学意义(P0.05)。在急性放射性唾液腺损伤程度方面,入组患者唾液腺损伤均集中在1-3级。治疗组与对照组在不同程度放射性唾液腺损伤程度发生率方面,差异具有统计学意义(P0.05);在3级唾液腺损伤中治疗组发生率为0%,对照组发生率为12%,说明治疗组可以减少严重层级的唾液腺损伤发生率。在放疗后生存质量比较方面,放疗后两组间患者均有不同程度的咽痛、口干、痰多表现。其中两组患者在咽痛、口干、疲劳、痰多程度方面,差异具有统计学意义(P0.05),治疗组上述症状的严重程度低于对照组;两组患者在失眠程度方面,差异不具有统计学意义(P0.05)。在KPS评分方面,我们分别在放射治疗前及治疗后进行组内比较,结果差异无统计学意义(P0.05);说明两组KPS基线平衡性良好,清热解毒益气养阴法在保持鼻咽癌放疗后患者行为体力状态方面未见显著疗效。在不良反应方面,两组血液系统、肝肾功能不良反应比较,两组差异无统计学意义(P0.05)。说明治疗组所使用中药患者耐受性良好。结论:清热解毒益气养阴法可以减少严重程度的急性放射性口咽粘膜反应、减少急性放射性皮肤反应、减少严重层级的唾液腺损伤发生率,提高患者在放疗后生存质量,试验药物耐受性良好。
[Abstract]:Objective: to observe the clinical effect of clearing heat and detoxifying qi and nourishing yin on the side effects of radiotherapy for nasopharyngeal carcinoma (NPC), and to compare the relative data between the treatment group and the observation group. To evaluate the clinical value of clearing heat and detoxifying qi and nourishing yin in the prevention and treatment of side effects of radiotherapy for nasopharyngeal carcinoma (NPC). Methods: 50 patients with nasopharyngeal carcinoma were randomly divided into treatment group (n = 25) and control group (n = 25). The difference between the two groups in KPS score, grade and time of acute radiation oropharyngeal mucosal injury, grade and time of acute radiation skin reaction, grade of acute radioactive salivary gland injury, quality of life after radiotherapy were compared between the two groups. Drug-related adverse reactions were evaluated. Results: in the grade and time of acute radiation oropharyngeal mucosal injury, the time of acute oropharyngeal mucosal reaction in the treatment group was higher than that in the control group. The difference was not statistically significant (P0.05); the incidence of acute oropharyngeal mucosal reaction in the treatment group was significantly lower than that in the control group (P0.05). The treatment group had obvious advantages. The average time of acute radiation skin reaction in the treatment group was later than that in the control group, the difference was statistically significant (P0.05), and the incidence of acute radiation skin reaction in the treatment group was higher than that in the control group (P0.05). The treatment group was lower than the observation group, the difference was statistically significant (P0.05); the treatment group had 3 grade acute radiation skin reaction rate compared with the control group, the difference was not statistically significant (P0.05). In acute radiation-induced salivary gland injury, the salivary gland injury was mainly in grade 1-3. The incidence of different degrees of radioactive salivary gland injury in the treatment group and the control group, The difference was statistically significant (P0.05); the incidence of salivary gland injury in the treatment group was 0, and that in the control group was 12, indicating that the treatment group can reduce the incidence of serious level of salivary gland injury. In the aspect of quality of life after radiotherapy, there were different degrees of pharynx, dry mouth and sputum between the two groups. Two groups of patients in pharynx, dry mouth, fatigue, sputum, the difference was statistically significant (P0.05), the treatment group in the severity of the symptoms compared with the control group; the two groups of patients in the degree of insomnia, the difference was not statistically significant (P0.05). In terms of KPS score, we compared the results before and after radiotherapy, the results were not statistically significant (P0.05), indicating that the KPS baseline balance between the two groups is good, The method of clearing away heat and detoxifying qi and nourishing yin has no significant effect on maintaining the behavioral physical state of patients with nasopharyngeal carcinoma after radiotherapy. In the side of adverse reactions, the two groups of blood system, liver and kidney function adverse reactions, there was no significant difference between the two groups (P0.05). The results showed that the patients in the treatment group had good tolerance. Conclusion: the method of clearing heat, detoxifying and supplementing qi and nourishing yin can reduce acute radiation oropharyngeal mucosal reaction, reduce acute radiation skin reaction, reduce the incidence of serious salivary gland injury, and improve the quality of life of patients after radiotherapy. The drug tolerance is good.
【学位授予单位】：广州中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R739.63
本文编号：2177617
[Abstract]:Objective: to observe the clinical effect of clearing heat and detoxifying qi and nourishing yin on the side effects of radiotherapy for nasopharyngeal carcinoma (NPC), and to compare the relative data between the treatment group and the observation group. To evaluate the clinical value of clearing heat and detoxifying qi and nourishing yin in the prevention and treatment of side effects of radiotherapy for nasopharyngeal carcinoma (NPC). Methods: 50 patients with nasopharyngeal carcinoma were randomly divided into treatment group (n = 25) and control group (n = 25). The difference between the two groups in KPS score, grade and time of acute radiation oropharyngeal mucosal injury, grade and time of acute radiation skin reaction, grade of acute radioactive salivary gland injury, quality of life after radiotherapy were compared between the two groups. Drug-related adverse reactions were evaluated. Results: in the grade and time of acute radiation oropharyngeal mucosal injury, the time of acute oropharyngeal mucosal reaction in the treatment group was higher than that in the control group. The difference was not statistically significant (P0.05); the incidence of acute oropharyngeal mucosal reaction in the treatment group was significantly lower than that in the control group (P0.05). The treatment group had obvious advantages. The average time of acute radiation skin reaction in the treatment group was later than that in the control group, the difference was statistically significant (P0.05), and the incidence of acute radiation skin reaction in the treatment group was higher than that in the control group (P0.05). The treatment group was lower than the observation group, the difference was statistically significant (P0.05); the treatment group had 3 grade acute radiation skin reaction rate compared with the control group, the difference was not statistically significant (P0.05). In acute radiation-induced salivary gland injury, the salivary gland injury was mainly in grade 1-3. The incidence of different degrees of radioactive salivary gland injury in the treatment group and the control group, The difference was statistically significant (P0.05); the incidence of salivary gland injury in the treatment group was 0, and that in the control group was 12, indicating that the treatment group can reduce the incidence of serious level of salivary gland injury. In the aspect of quality of life after radiotherapy, there were different degrees of pharynx, dry mouth and sputum between the two groups. Two groups of patients in pharynx, dry mouth, fatigue, sputum, the difference was statistically significant (P0.05), the treatment group in the severity of the symptoms compared with the control group; the two groups of patients in the degree of insomnia, the difference was not statistically significant (P0.05). In terms of KPS score, we compared the results before and after radiotherapy, the results were not statistically significant (P0.05), indicating that the KPS baseline balance between the two groups is good, The method of clearing away heat and detoxifying qi and nourishing yin has no significant effect on maintaining the behavioral physical state of patients with nasopharyngeal carcinoma after radiotherapy. In the side of adverse reactions, the two groups of blood system, liver and kidney function adverse reactions, there was no significant difference between the two groups (P0.05). The results showed that the patients in the treatment group had good tolerance. Conclusion: the method of clearing heat, detoxifying and supplementing qi and nourishing yin can reduce acute radiation oropharyngeal mucosal reaction, reduce acute radiation skin reaction, reduce the incidence of serious salivary gland injury, and improve the quality of life of patients after radiotherapy. The drug tolerance is good.
【学位授予单位】：广州中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R739.63
【参考文献】
相关期刊论文 前10条
1 瞿燕平;金燕;;中医综合护理干预对鼻咽癌放疗患者口咽部真菌感染的效果观察[J];西部中医药;2016年10期
2 白燕;江志兰;刘雪梅;王继红;;调强放射治疗鼻咽癌急性毒副反应的临床护理[J];中国实用医药;2015年19期
3 黄祥;曲超;姜新;董丽华;曲雅勤;;鼻咽癌的治疗进展[J];中国老年学杂志;2015年11期
4 张春丽;;益气养阴解毒方对鼻咽癌放疗患者生存质量的影响[J];中医学报;2015年06期
5 周春友;;鼻咽癌患者放疗后中医证候分析[J];临床医药文献电子杂志;2015年10期
6 周昌胤;张小娟;袁先平;杨田福;车忠慧;;中西医结合治疗鼻咽癌放疗后分泌性中耳炎的疗效观察[J];中医临床研究;2015年07期
7 王靖思;孙桂芝;吴洁;;孙桂芝诊治鼻咽癌经验介绍[J];辽宁中医杂志;2015年02期
8 邓飞;李拥军;蔡正斌;黄薇隗;;滋阴清热法治疗鼻咽癌放射性口腔炎疗效观察[J];四川中医;2015年02期
9 张云芳;张明;;加味增液汤治疗鼻咽癌放疗后口干症的疗效观察[J];现代中西医结合杂志;2015年03期
10 周瑶;唐毅;;养阴清热合剂治疗头颈部肿瘤放疗后口干症的应用[J];中国中医药现代远程教育;2015年01期
相关硕士学位论文 前2条
1 陈新勇;切脉针灸改善鼻咽癌放疗后患者生存质量的研究[D];广州中医药大学;2013年
2 景艳;5种中药体外抗鼻咽癌作用筛选及石上柏提取物诱导鼻咽癌细胞凋亡机制的研究[D];广西医科大学;2010年
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