生脉饮加味治疗鼻咽癌放疗时涎腺受损临床研究.docVIP

生脉饮加味治疗鼻咽癌放疗时涎腺受损临床研究 　　[摘要] 目的:探讨应用生脉饮加味方剂治疗鼻咽癌放疗时唾液腺受损的临床疗效。方法:将96例首次根治性放射性治疗的鼻咽癌患者随机分为实验组(放疗加药物)和对照组(单纯放疗),每组48例,放疗总剂量DT 60～70 Gy,6～7周,常规分割,放射野均包括面颈联合野。唾液腺受损程度通过视觉模拟评分法(VAS)和滤纸洇湿时间评定。结果:实验组口干程度VAS评分低于对照组(P0.01),唾液分泌量高于对照组(P0.01)。结论:生脉饮加味疗法能有效预防鼻咽癌放疗时涎腺功能受损,口干症状减轻,生活质量提高。 　　[关键词] 生脉饮加味;鼻咽癌;涎腺受损 　　[中图分类号] R273[文献标识码]A [文章编号]1673-7210(2010)06(a)-013-03 　　 　　Clinical research of Shengmaiyin Jiawei treating salivary gland damaged by nasopharyngeal carcinoma radiotherapy 　　LIU Shumei 　　(Heze Municipal Hospital, Heze 274031, China) 　　[Abstract] Objective: To explore the effect of Shengmaiyin Jiawei in preventing salivary gland damaged by nasoparyngeal carcinoma radiotherapy. Methods: 96 patients with nasopharyngeal carcinoma received curative radiotherapy were randomly divided into two groups: experiment group (radiotherapy and traditional and Chinese medicine) and control group (pure radiotherapy). Total dose of radiotherapy was 60-70 Gy, 6-7 weeks, conventional fractioned, radiotherapy field included face and neck coalition. The level of salivary gland damaged was checked by the visual analogue scale (VAS) and the time of waterish filter paper. Results: The VAS of the experimental group was less than the control group in the dryness of the mouth (P0.01); in the quantity of salivary secretion, the former was higher than the later (P0.01). Conclusion: Shengmaiyin Jiawei can prevent from salivary gland damaged and abate the symptom of dryness of the mouth effectively, and improve the quality of life. 　　[Key words] Shengmaiyin Jiawei; Nasopharyngeal carcinoma; Salivary gland damage 　　 　　面颈联合野照射是鼻咽癌治疗采用的主要方法,由于其放射野主要包括几乎整个腮腺与颌下腺组织,使其受到较高剂量照射,引起唾液腺功能减退不可避免[1]。口干不适、吞咽困难、龋齿、口腔易感染,严重影响患者生存质量。为此,2004年3月～2009年5月,笔者采用放疗的同时给予生脉饮加味方剂口服,观察该方剂对放射线引起的唾液腺功能损伤的保护作用。 　　1 资料与方法 　　1.1 一般资料 　　2004年3月～2009年5月在我院确诊的鼻咽癌患者,符合以下条件者入组:①鼻咽癌均经鼻咽镜活检取得病理或经过颈部淋巴结切除活检,临床TNM分期标准根据中国鼻咽癌92分期确定[2];②所有病例均由病理证实;③年龄25～66岁;④所有患者均为首次根治性治疗,照射野主要包括双侧面颈联合野,其中涎腺接受的放射剂量DT≥60 Gy;⑤无严重系统性疾病,无涎腺病史;⑥体能状态(K