摘要
【目的】观察中药溃疡油防治头颈部肿瘤放疗所致皮肤损伤的疗效。【方法】将60例接受放射治疗的头颈部肿瘤患者随机分为治疗组和对照组,每组各30例。治疗组在每次放疗结束后照射野皮肤外敷中药溃疡油至放疗疗程结束,对照组照射野皮肤予比亚芬软膏处理。比较2组在放射治疗过程中放射性皮炎的发生率、放射性皮炎分级、发生放射性皮肤损伤的照射剂量及药物不良反应等。【结果】2组患者放射性皮肤损伤发生率均为100%,其中轻度放射性皮炎(Ⅰ级+Ⅱ级)治疗组22例(占73.0%)、对照组12例(占40.0%),中重度放射性皮炎(Ⅲ级)治疗组8例(占27.0%)、对照组18例(占60.0%)。2组轻、中度放射性皮炎发生率比较,差异有显著性意义(P<0.05),而且治疗组皮肤损伤发生的严重程度低于对照组,提示溃疡油能在一定程度上预防中重度皮肤损伤的发生。皮肤放射性损伤出现于照射剂量40Gy以前治疗组7例(21.2%)、对照组18例(60.0%),出现于照射剂量40Gy以后治疗组23例(78.8%)、对照组12例(40.0%),2组皮肤放射性损伤率比较,差异有显著性意义(P<0.05)。创面新生皮肤黏膜修复平均时间治疗组为(7.13±1.61)d,对照组为(9.68±2.23)d,2组比较差异有显著性意义(P<0.05)。放射治疗后患者的生存质量以稳定和降低为主,2组比较差异无显著性意义(P>0.05)。两组未见急性毒性或不良反应。【结论】中药溃疡油能有效地预防放射性皮炎的发生,加速创面的愈合,能减轻患者痛苦、减轻放射治疗副反应,保证放射治疗的顺利进行。临床应用中药溃疡油治疗未见任何毒副反应的发生。
Objective To observe the therapeutic efficacy of Chinese herbal medicine of Ulcer Oil on cutaneous injury induced by radiotherapy for head and neck tumors. Methods Sixty patients with head and neck tumor were randomized into two groups, Group A （as experimental group） and Group B （as control group）. In Group A, 30 patients were treated with Ulcer Oil since the first session of radiotherapy till the last one. In Group B, 30 patients were given Trolamine Ointment since the first radiotherapy session. The incidence and the classification of radiodermatitis as well as the radiation dose inducing skin radioreaction in the two groups were evaluated after radiotherapy. The side effect of Ulcer Oil was also monitored. Results The incidence of the skin-reaction was 100% in the patients of both groups but with a difference of severity. Slight radiodermatitis （ Grade Ⅰ and Grade Ⅱ） was 73.0% in Group A, and 40. 0% in Group B, which had significant difference （P 〈0. 05）. A middle-severe reaction （ Grade-Ⅲ ） radiation reaction was 27.0% in Group A, and 60. 0% in Group B. There was a significant difference between the two groups （P 〈 0.05 ）. The radiation reaction severity on Group A was much lower than that of Group B. Therefore, Ulcer Oil played an important role in the prevention of cutaneous injury severity. Based on the degree of the skin reaction, there was 21.2% patients （7 cases） who had skin radioaction before the patients received a dose of 40 Gy in Group A, and in 60.0% （18 cases） in Group B. Nevertheless, there was 78.8% patients （23 cases） who had skin radioaction after the patients received a dose over 40 Gy in Group A, and in 40.0% （22 cases） in Group B. There was a significant difference between the two groups （P 〈0.05）. In other words, obvious radiodermatitis mostly occurred after the patients received a dose over 40 Gy, especially in the peak dose between 60 to 70 Gy. The mean time for the recovery of newborn skin and mucous membrane in wound surface was （7.13 ±1.61） days in Group A and （9.68±2.23） days in Group B . There was a significant difference （P 〈 0.05 ） between the two groups. The patients＇ quality of life after radiotherapy was focused on its stability, which had no significant difference （P 〉 0.05 ）. No acute toxicity or other adverse drug reactions were detected in patients of the two groups. Conclusion Ulcer Oil is effective for the prevention and treatment of radiodermatitis in head and neck tumors patients through decreasing the incidence, promoting wound curing, and relieving pain and side effect of radiotherapy.
出处
《广州中医药大学学报》
CAS
2010年第5期474-477,481,共5页
Journal of Guangzhou University of Traditional Chinese Medicine
