溃疡油加甘露饮治疗放射性食管炎的临床疗效观察

发布时间：2018-04-24 03:27

本文选题：放射性食管炎 + 甘露饮　；参考：《北京中医药大学》2012年硕士论文

【摘要】：本文包括文献综述和临床研究两部分。目的：恶性肿瘤已成为常见病,每年的发病率和死亡率都成上升趋势,放射治疗是与手术、化疗并驾齐驱的三驾马车之一,但是食管是剂量限制性器官,当胸部恶性肿瘤放疗时,很多患者会出现急性放射性食管炎(Acute Radiation Esophagitis, ARE),影响放疗的继续进行,而目前临床上尚无统一的治疗指南,所以研究进一步治疗ARE的方法。方法：①在放疗中出现放射性食管炎时开始口服甘露饮(熟地黄10g、生地黄10g、天门冬10g、麦门冬10g、石斛10g、黄芩10g、枇杷叶10g、茵陈10g、枳壳10g、甘草10g),院内中药房制取200m1/袋,1袋/次,2次/d,服药后半小时禁饮水。如疼痛较剧烈者,加元胡15g；伴便秘者,加大黄6g,厚朴15g；吞咽困难较严重者,可加全瓜蒌30g,浙贝10g。②另服科内制剂溃疡油(主要成分为：大黄、当归、红花、紫草)：3次/d,10mml/次,徐徐含咽,服药后半小时内禁饮水。若疼痛明显者可将剂量增大至4次/d,20m1/次,待症状缓解后可减至原量,直至显效。对照组：在放疗中出现放射性食管炎症状时服用康复新液10mL/次,3次/d常规治疗,徐徐含咽,服药后半小时内禁饮水。结果：治疗3周后,吞咽疼痛、吞咽困难症状都得到明显改善,其中吞咽疼痛缓解率评价,治疗组8人全部缓解,而对照组有1人未缓解,总有效率治疗组高于对照组,P=0.6940.05,不具有统计学差异,考虑原因可能与观察例数较少,样本量不足有一定关系；而吞咽困难缓解率评价,治疗组吞咽困难10例,3周后9例达到显效,仅有1例无效；对照组吞咽困难共10例,3周内显效5例,有效3例,无效2例,总有效率治疗组大于对照组,P=0.1650.05,不具有统计学差异,考虑原因可能与观察例数较少,样本量不足有一定关系。经治疗3周后,治疗组舌质由红舌转为淡红舌3例,而对照组仅1例；治疗组舌苔由腻苔转为薄黄苔的有7例,而对照组仅2例。脉象上,经治疗3周后,治疗组细脉消失,滑脉多见,弦、数脉仍明显；对照组细脉较治疗前减少2例,余脉象变化不大。结论：用溃疡油加甘露饮后,患者体内的湿热症状得到部分缓解。甘露饮和溃疡油能更好的恢复津液,减轻火热毒邪的危害。两组患者仍有明显弦脉,说明体内的痰瘀未得到根本消除；故溃疡油加甘露饮能改善吞咽疼痛、吞咽困难等症状,能改善放疗期间的热象,改善放疗期间的阴虚症状。
[Abstract]:This article includes literature review and clinical study .

Objective : The incidence and mortality of malignant tumors have become common diseases , and the incidence and mortality of malignant tumors are rising . However , the esophagus is a dose - limiting organ . When the chest malignant tumor is radiotherapy , many patients will have acute radiation esophagitis ( ARE ) , which affects the continuation of radiotherapy .
With constipation , 6 g of yellow and 15 g of magnolia officinalis were added ;
In the control group , the dosage can be increased to 4 times / day and 20 ml / time .

Results : After 3 weeks of treatment , the symptoms of swallowing pain and swallowing were obviously improved , in which the rate of swallowing pain was evaluated , 8 in the treatment group were relieved completely , while 1 in the control group was not relieved , the total effective rate was higher than that of the control group , P = 0.6940 . 05 .
In the treatment group , there were 10 cases and 9 cases after 3 weeks . Only 1 case was ineffective .
There were 10 cases in the control group , 5 cases were effective in 3 weeks , 3 cases were effective and 2 cases were ineffective . The total effective rate was more than that in the control group , P = 0.1650 . 05 . There was no statistical difference . The reason might be related to the number of observation cases and insufficient sample size . After 3 weeks of treatment , the tongue of the treatment group changed from red tongue to pale red tongue in 3 cases , while only 1 case in the control group .
In the treatment group , the tongue coating changed from greasy tongue to thin yellow tongue in 7 cases , while only 2 cases in the control group . After 3 weeks of treatment , the treatment group had disappeared , and the pulse was more frequent , and the pulse remained obvious .
Conclusion : In the control group , the symptoms of damp - heat in the body can be partially alleviated after the treatment of ulcer oil with mannitol . Conclusion : After the ulcer oil is added with mannose , the symptoms of damp - heat in the body are partially relieved . Both the mannitol and the ulcer oil can better recover the body fluid and reduce the harm of heat toxin .
Therefore , the ulcer oil and the mannose can improve the symptoms of swallowing pain , difficulty in swallowing and the like , can improve the thermal image during radiotherapy and improve the symptoms of yin deficiency during radiotherapy .

【学位授予单位】：北京中医药大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R818

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