加味养阴清肺汤防治急性放射性口腔炎与临床观察.docVIP

加味养阴清肺汤防治急性放射性口腔炎的临床观察* 沈红梅1贾立群2 黄 杰1赵 丽1 王轶珊1 朱德志1 昆明医学院第三附属医院 云南省肿瘤研究所中西医结合肿瘤临床研究中心 北京中日友好医院 [摘要] 目的 探讨加味养阴清肺汤防治急性放射性口腔炎的疗效和对唾液中表皮生长因子EGF的影响。方法 将80例鼻咽癌行根治性放疗的患者随机分为2组，每组40例，治疗组每天含服中药加味养阴清肺汤，对照组从放疗剂量达20Gy后每天含漱西药漱口水。观察两组病例放射性口腔炎发生率，用ELISA法检测唾液中EGF。结果 随着放疗剂量增加，两组患者Ⅲ、Ⅳ度口腔黏膜反应的发生率显著增加（P均＜0.05）。但治疗组患者Ⅲ、Ⅳ度口腔黏膜反应的发生率始终低于对照组（P均＜0.05）。放疗前两组唾液EGF含量无显著性差异（P=0.879），随着放疗剂量的增加，两组唾液EGF含量呈下降趋势，有显著的统计学意义（P均=0.000）。治疗组下降程度均较对照组轻，差异有显著意义（P均＜0.05）。结论 加味养阴清肺汤对急性放射性口腔黏膜炎的预防性治疗效果显著，其作用机制可能是通过提高唾液EGF水平，促进口腔组织[关键词] 加味养阴清肺汤 放射性口腔炎 表皮生长因子 Clinical observation of treatment of acute radiation-induced stomatitis by Modified Yangyin Qingfei decoction Hongmei Shen liqun jia jie huang li zhao yishan wang dezhi zhu The Third Affiliated Hospital of Kunming Medical University, Cancer Clinical Research Center of Integrated Traditional and Western Medicine [Abstract] Purpose: To explore the effect of acute radiation-induced stomatitis by Modified Yangyin Qingfei decoction on treatment outcome and the levels of epidermal *基金项目：云南省自然科学基金（NO.2009CD182）；云南省卫生厅科技计划项目(2010NS086)；云南省教育厅科学研究基金(NO.07Y10626)。 通讯作者：沈红梅，副主任医师，工作单位：昆明医学院第三附属医院云南省肿瘤研究所中西医结合肿瘤临床研究中心，云南，昆明，邮政编码：650118。 growth factor (EGF) in saliva. Methods: 80 cases with a radical radiotherapy were divided into 2 groups randomly, 40 cases in the treatment group and 40 cases in the control group .The treatment group was treated by Modified Yangyin Qingfei decoction after the initiation of radiotherapy. The control group was treated by the regular western medicine mouthwash after DT=20Gy. The incidence rates of stomatitis and the levels of EGF in saliva were measured. Results: As the increasing dose of radiotherapy, the incidence rates of III-degree and IV-degree stomatitis were increased significantly in the two groups (P0.05). However, the incidence rate of treatment group was lower than that of control group (P0.05). The levels of EGF in two groups showed no differences before the initiation of radiotherapy (P=0.879).