加味冰硼散漱口液对放射性口腔黏膜炎炎性介质及预后的影响分析
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摘要
目的:分析加味冰硼散漱口液对放射性口腔黏膜炎患者炎性介质及预后的影响。方法:选取77例放射性口腔黏膜炎患者作为研究对象。随机分为观察组与对照组,对照组患者给予常规的化学疗法,观察组患者给予加味冰硼散漱口液进行治疗,并比较治两组患者放疗到出现急性黏膜炎的时间以及耐受剂量,不同时期患者外周血以及唾液中的炎症细胞因子以及临床治疗效果。结果:经治疗后,观察组患者从放疗治疗开始到出现急性黏膜炎的时间以及放疗的耐受剂量均显著高于对照组患者,差异具有统计学意义(P<0.05);在进行放疗之前,观察组患者唾液以及外周血液中的炎症因子IFN-γ、TNF-α、IL-6的值差异不明显,差异不具有统计学意义(P>0.05);放疗中与放疗后,观察组患者唾液以及外周血液中的炎症因子IFN-γ、TNF-α、IL-6均显著低于对照患者,差异具有统计学意义(P<0.05);观察组患者的临床治疗总有效率96.97%显著高于对照患者的临床治疗总有效率79.41%,差异具有统计学意义(P<0.05)。结论:采用加味冰硼散漱口液对放射性口腔黏膜炎患者进行治疗,其治疗效果较好,并且能够显著改善患者唾液以及外周血中的炎症因子水平,利于疾病的康复,值得临床推广应用。
Objective: To analyze the effect of Modified Bingpeng mouthwash on inflammatory mediators and prognosis in patients with radioactive oral mucositis. Methods: Seventy-seven patients with radioactive oral mucositis were selected as subjects. They were randomly divided into observation group and control group. Patients in the control group were given conventional chemotherapy. The patients in the observation group were treated with Modified Bingpeng mouthwash, and the time between the two groups of patients receiving radiotherapy to acute mucositis and the tolerated dose were compared. Inflammatory cytokines in peripheral blood and saliva of patients at different stages and clinical treatment effects were observed. Results: After treatment, the time from radiotherapy to acute mucositis and the dose of radiotherapy in the observation group were significantly higher than those in the control group(P<0.05). Before radiotherapy, the inflammatory factors IFN-γ, TNF-α and IL-6 in the saliva and peripheral blood of the observation group were not significantly different and the difference was not statistically significant(P>0.05). After radiotherapy and radiotherapy, the saliva of the observation group was observed. The inflammatory factors IFN-γ, TNF-α and IL-6 in peripheral blood were significantly lower than those in the control group and the difference was statistically significant(P<0.05). The total effective rate of clinical treatment in the observation group was significantly higher than 96.97%. The total effective rate of clinical treatment in the control patients was 79.41% and the difference was statistically significant(P<0.05). Conclusion: The treatment of patients with radioactive oral mucositis with Modified Bingpeng mouthwash is better and can significantly improve the level of inflammatory factors in the saliva and peripheral blood of patients, which is conducive to the rehabilitation of the disease. It is worthy of clinical application.
Objective: To analyze the effect of Modified Bingpeng mouthwash on inflammatory mediators and prognosis in patients with radioactive oral mucositis. Methods: Seventy-seven patients with radioactive oral mucositis were selected as subjects. They were randomly divided into observation group and control group. Patients in the control group were given conventional chemotherapy. The patients in the observation group were treated with Modified Bingpeng mouthwash, and the time between the two groups of patients receiving radiotherapy to acute mucositis and the tolerated dose were compared. Inflammatory cytokines in peripheral blood and saliva of patients at different stages and clinical treatment effects were observed. Results: After treatment, the time from radiotherapy to acute mucositis and the dose of radiotherapy in the observation group were significantly higher than those in the control group(P<0.05). Before radiotherapy, the inflammatory factors IFN-γ, TNF-α and IL-6 in the saliva and peripheral blood of the observation group were not significantly different and the difference was not statistically significant(P>0.05). After radiotherapy and radiotherapy, the saliva of the observation group was observed. The inflammatory factors IFN-γ, TNF-α and IL-6 in peripheral blood were significantly lower than those in the control group and the difference was statistically significant(P<0.05). The total effective rate of clinical treatment in the observation group was significantly higher than 96.97%. The total effective rate of clinical treatment in the control patients was 79.41% and the difference was statistically significant(P<0.05). Conclusion: The treatment of patients with radioactive oral mucositis with Modified Bingpeng mouthwash is better and can significantly improve the level of inflammatory factors in the saliva and peripheral blood of patients, which is conducive to the rehabilitation of the disease. It is worthy of clinical application.
引文
[1] 吕丹妮,李容林,杨光伟,等.放射治疗和化学治疗诱发性口腔黏膜炎的防治[J].国际口腔医学杂志,2015,42(2):177-180.
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[7] 龚芸,陈富超,汪少华,等.口炎清颗粒联合西帕依固龈液治疗鼻咽癌放射性口腔黏膜炎的疗效观察[J].现代药物与临床,2016,31(8):1249-1252.
[8] 李本珊,黄纪逸,梁梅兴.红豆利咽汤治疗急性放射性口腔黏膜炎的临床研究[J].中医临床研究,2017,9(19):45-47.
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[10] 徐新颜,万彦婷,洪燕,等.珍黄丸防治局部晚期鼻咽癌治疗中放射性口咽炎30例[J].江西中医药大学学报,2013,25(6):12-14.
[11] 韩亚骞,张姗姗,吴湘玮,等.含rhGM-CSF漱口液治疗放射性口腔黏膜炎的前瞻性随机对照研究[J].肿瘤,2014,34(1):72-77.
[12] Wu MH,Yuan B,Liu QF.Study of Qingre Liyan Decoction in treating and preventing acute radioactive oral mucositis[J].Chinese Journal of Integrative Medicine,2007,13(4):280-284.
[13] 吴莹嘉,郭素萍,陈建珠,等.放射性口腔黏膜炎患者应用芬太尼透皮贴剂止痛的效果观察[J].中华护理杂志,2013,48(5):467-468.
[14] 鲁华,李霞,董元玲,等.比亚芬复合冰片对鼻咽癌患者放射性口腔黏膜炎及张口困难的影响[J].护士进修杂志,2015,30(10):942-944.
[15] 黄惠明,张少群,卢妍.口腔溃疡含漱液防治鼻咽癌放射性口腔黏膜炎的效果观察[J].护理与康复,2015,14(7):651-653.
[16] 韩俊庆,俞新爽,丁晓,等.中药预防性治疗急性放射性口腔黏膜炎的临床研究[J].中国癌症杂志,2008,18(4):294-297.
[17] 龚芸,陈富超,汪少华,等.口炎清颗粒联合西帕依固龈液治疗鼻咽癌放射性口腔黏膜炎的疗效观察[J].现代药物与临床,2016,31(8):1249-1252.
[18] 朱蓉,唐世芳,陈义伟,等.氦氖激光口腔内照射对鼻咽癌患者放射性张口困难的影响[J].中华护理杂志,2014,49(12):1475-1479.
[19] 汪跃平,李春阳,杨光伟,等.仙方活命饮加减方与西帕依固龈液治疗放射性口腔黏膜炎临床疗效比较分析[J].中华中医药杂志,2011,10(8):1740-1743.
[20] 罗鹏辉,毛艳,李黎,等.重组人白介素11联合传统含漱液防治鼻咽癌放射性口腔黏膜炎的疗效观察[J].海南医学,2016,27(24):3997-4000.
[2] 倪杰,陆勤美,周晓梅,等.全程护理干预对鼻咽癌调强放射治疗病人口腔黏膜炎的影响[J].护理研究,2015,12(8):993-996.
[3] Ahmadi A.Potential prevention:Aloe vera mouthwash may reduce radiation-induced oral mucositis in head and neck cancer patients[J].Chinese Journal of Integrative Medicine,2012,18(8):635-640.
[4] 吴莹嘉,郭素萍,陈建珠,等.放射性口腔黏膜炎患者应用芬太尼透皮贴剂止痛的效果观察[J].中华护理杂志,2013,48(5):467-468.
[5] 达林泰,包晶晶,鲍琢,等.放射性口腔黏膜炎治疗防护进展[J].现代仪器与医疗,2013,19(2):11-15.
[6] Dorina,Lauritano,Massimo,et al.Clinical effectiveness of palifermin in prevention and treatment of oral mucositis in children with acute lymphoblastic leukaemia:a case-control study[J].International Journal of Oral Science,2014,6(1):27.
[7] 龚芸,陈富超,汪少华,等.口炎清颗粒联合西帕依固龈液治疗鼻咽癌放射性口腔黏膜炎的疗效观察[J].现代药物与临床,2016,31(8):1249-1252.
[8] 李本珊,黄纪逸,梁梅兴.红豆利咽汤治疗急性放射性口腔黏膜炎的临床研究[J].中医临床研究,2017,9(19):45-47.
[9] Li WU,Liu Z,Zhao D.Effects of Yangyin Jiedu Decoction on Acute Oral Mucositis Caused by Radiation[J].Medicinal Plant,2018,12(3):28-32.
[10] 徐新颜,万彦婷,洪燕,等.珍黄丸防治局部晚期鼻咽癌治疗中放射性口咽炎30例[J].江西中医药大学学报,2013,25(6):12-14.
[11] 韩亚骞,张姗姗,吴湘玮,等.含rhGM-CSF漱口液治疗放射性口腔黏膜炎的前瞻性随机对照研究[J].肿瘤,2014,34(1):72-77.
[12] Wu MH,Yuan B,Liu QF.Study of Qingre Liyan Decoction in treating and preventing acute radioactive oral mucositis[J].Chinese Journal of Integrative Medicine,2007,13(4):280-284.
[13] 吴莹嘉,郭素萍,陈建珠,等.放射性口腔黏膜炎患者应用芬太尼透皮贴剂止痛的效果观察[J].中华护理杂志,2013,48(5):467-468.
[14] 鲁华,李霞,董元玲,等.比亚芬复合冰片对鼻咽癌患者放射性口腔黏膜炎及张口困难的影响[J].护士进修杂志,2015,30(10):942-944.
[15] 黄惠明,张少群,卢妍.口腔溃疡含漱液防治鼻咽癌放射性口腔黏膜炎的效果观察[J].护理与康复,2015,14(7):651-653.
[16] 韩俊庆,俞新爽,丁晓,等.中药预防性治疗急性放射性口腔黏膜炎的临床研究[J].中国癌症杂志,2008,18(4):294-297.
[17] 龚芸,陈富超,汪少华,等.口炎清颗粒联合西帕依固龈液治疗鼻咽癌放射性口腔黏膜炎的疗效观察[J].现代药物与临床,2016,31(8):1249-1252.
[18] 朱蓉,唐世芳,陈义伟,等.氦氖激光口腔内照射对鼻咽癌患者放射性张口困难的影响[J].中华护理杂志,2014,49(12):1475-1479.
[19] 汪跃平,李春阳,杨光伟,等.仙方活命饮加减方与西帕依固龈液治疗放射性口腔黏膜炎临床疗效比较分析[J].中华中医药杂志,2011,10(8):1740-1743.
[20] 罗鹏辉,毛艳,李黎,等.重组人白介素11联合传统含漱液防治鼻咽癌放射性口腔黏膜炎的疗效观察[J].海南医学,2016,27(24):3997-4000.