CAJ | 학술논문

目的探讨痰热清注射液预防和治疗头颈部恶性肿瘤化疗所致急性口腔黏膜炎的临床疗效.方法将2011年1月~2012年4月在我院首诊为头颈部恶性肿瘤且行化疗的患者120例随机分为3组,即对照组、治疗组和预防组,每组各40例,3组均采用5-氟尿嘧啶(5-Fu)联合顺铂(PDD)方案行诱导化疗,对照组化疗后出现口腔黏膜炎时予生理盐水联合庆大霉素、地塞米松、维生素B6配成漱口液,含漱3~5次/日,结合口溃散对症处理;治疗组于患者出现口腔黏膜炎时除给予对照组的常规治疗外,加用痰热清注射液治疗,预防组于开始化疗后同时予痰热清注射液治疗.治疗结束后比较三组口腔黏膜炎的发生率、化疗开始至发生口腔黏膜炎的时间、口腔炎平均治愈时间及不良反应的发生情况.结果对照组、治疗组和预防组口腔炎的发生率分别为87.5%、92.5%和80.0%,治疗组与对照组比较差异无统计学意义(P>0.05).而预防组较前两组显著降低(P<0.05).对照组、治疗组和预防组的重度口腔炎(Ⅲ~Ⅳ级)发生率分别为52.5%、57.5%和27.7%,治疗组与对照组比较差异无统计学意义(P>0.05),而预防组显著低于前两组(P<0.05).对照组、治疗组和预防组从开始接受化疗到开始出现口腔炎的平均时间分别为7.3天、7.8天、13.3天,治疗组与对照组比较差异无统计学意义(P>0.05),而预防组与前两组相比显著延长(P<0.05).对照组、治疗组和预防组口腔炎平均治愈时间分别为7.5天、4.6天、3.5天,治疗组的平均治愈时间明显短于对照组(P<0.05),预防组的平均治愈时间明显短于前两组(P<0.05).结论预防使用痰热清注射液可对头颈部肿瘤诱导化疗后口腔黏膜炎起到良好的预防和治疗作用,值得临床推广.
목적탐토담열청주사액예방화치료두경부악성종류화료소치급성구강점막염적림상료효.방법장2011년1월~2012년4월재아원수진위두경부악성종류차행화료적환자120례수궤분위3조,즉대조조、치료조화예방조,매조각40례,3조균채용5-불뇨밀정(5-Fu)연합순박(PDD)방안행유도화료,대조조화료후출현구강점막염시여생리염수연합경대매소、지새미송、유생소B6배성수구액,함수3~5차/일,결합구궤산대증처리;치료조우환자출현구강점막염시제급여대조조적상규치료외,가용담열청주사액치료,예방조우개시화료후동시여담열청주사액치료.치료결속후비교삼조구강점막염적발생솔、화료개시지발생구강점막염적시간、구강염평균치유시간급불량반응적발생정황.결과대조조、치료조화예방조구강염적발생솔분별위87.5%、92.5%화80.0%,치료조여대조조비교차이무통계학의의(P>0.05).이예방조교전량조현저강저(P<0.05).대조조、치료조화예방조적중도구강염(Ⅲ~Ⅳ급)발생솔분별위52.5%、57.5%화27.7%,치료조여대조조비교차이무통계학의의(P>0.05),이예방조현저저우전량조(P<0.05).대조조、치료조화예방조종개시접수화료도개시출현구강염적평균시간분별위7.3천、7.8천、13.3천,치료조여대조조비교차이무통계학의의(P>0.05),이예방조여전량조상비현저연장(P<0.05).대조조、치료조화예방조구강염평균치유시간분별위7.5천、4.6천、3.5천,치료조적평균치유시간명현단우대조조(P<0.05),예방조적평균치유시간명현단우전량조(P<0.05).결론예방사용담열청주사액가대두경부종류유도화료후구강점막염기도량호적예방화치료작용,치득림상추엄.
Objective To explore the clinical efficacy of TanReQing injection in the prevention and treatment of chemo-therapy induced oral mucositis in head and neck neoplasm. Methods From January 2011 to April 2012, 120 patients who were firstly diagnosed with head and neck malignant tumor and were treated with chemotherapy in our hospital were randomly divided into control group, treatment group and prevention group, 40 cases in each group. Patients of the three groups were treated with 5-fluorouracil (5-Fu) plus cisplatin (PDD) scheme of induction chemotherapy. When patients in the control group and treatment group had oral mucositis after chemotherapy, they were treated with gargles of Saline plus gentamicin, dexamethasone, vitamin B6, three to five times per day, combined with symptomatic treatment by oral ulcer powder. But patients in treatment group got Tanreqing injection in addition. Patients in prevention group were treated as treatment group but they were treated by Tanre-qing injection at the beginning of chemotherapy. After treatment, three groups were compared in oral mucositis occurence rate, the time from the beginning of chemotherapy to the oral mucositis occurrence, the average healing time and the occurrence of adverse drug reactions. Results The oral mucositis occurrence rate in control group, treatment and prevention group were re-spectively 87.5%, 92.5%and 80%. There were no significant difference between the treatment group and the control group (P>0.05), while the oral mucositis occurrence rate in prevention group were significantly lower than that in the previous two groups (P<0.05). The occurrence rate of severe oral mucositis (Ⅲ~Ⅳ) in the control group, treatment and prevention group were 52.5%, 57.5%and 27.7% respectively;the rate had no significant difference between the treatment group and control group (P>0.05), but was significantly lower in the prevention group (P<0.05). The average time from the beginning of chemotherapy to the oral mucositis occurrence were respectively 7.3 days, 7.8 days, 13.3 days in the control, treatment and prevention group;It showed no significant difference between the treatment group and control group (P>0.05), but was significantly prolonged in the prevention group (P<0.05). It took respectively 7.5 days, 4.6 days, 3.5 days on average for the control, treatment and prevention group to get oral mucositis healed;it took significantly shorter time for the treatment group than the control group (P<0.05) and much shorter time for the prevention group than the former two groups (P<0.05). Conclusion Tanreqing injection played a good role in the prevention and treatment on chemotherapy induced oral mucositis of patients with head and neck neoplasm, thus was worthy of clinical application.