Clinical Effect of Kan Fu Xin Combined with Montmorillonite on the Prevention and Treatment of Radiation-induced Oral Mucositis in Patients with Head and Neck Cancer
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摘要:
目的 观察康复新联合蒙脱石散防治放射性口腔黏膜炎的效果，寻找一种有效、安全的防治方法，减轻患者痛苦。 方法 将2018年4月至2019年2月在云南省第一人民医院行放疗的138例头颈部肿瘤患者随机分为试验组和对照组，各69例。对照组给予常规护理和对症处理，试验组在在常规护理基础上给予蒙脱石散 + 康复新保护，将1袋蒙脱石散（3 g）与适量的康复新液调成糊状，于每次放疗前5 min和睡前含于口内。观察患者的放射性口腔黏膜损伤程度、口腔放射性疼痛程度、放疗完成时间及恢复情况等。 结果 试验组较对照组放射性口腔黏膜炎发生时间晚、恢复时间短，两者比较差异有统计学意义（P < 0.05）。放疗第3、4周，试验组RTOM以轻、中度为主，观察组以中、重度为主；第5、6周, 试验组RTOM以中度为主, 观察组以重度为主。第3～6周，2组间不同程度RTOM发生率比较差异有统计学意义（P < 0.01）。试验组的平均放疗时间少于对照组，差异有统计学意义（P < 0.05）。 结论 康复新联合蒙脱石散能明显减轻发生放射性口腔黏膜炎患者的症状，保证了放疗按时完成，可广泛应用于临床。 Abstract:Objective To observe the effect of Kan Fu Xin combined with Montmorillonite on the prevention and treatment of radiation-induced oral mucositis in patients with Head and Neck Cancer. Methods In this trial, we included 138 patients with head and neck cancer who underwent radiotherapy from the First People’ s Hospital of Yunnan Province from April 2018 to February 2019, which were randomly divided into the experimental group （69 cases） and the control group （69 cases）. The control group received routine care and symptomatic treatment. The experimental group gave Kan Fu Xin combined with Montmorillonite protection on the basis of routine care, and adjusted 1 bag of Montmorillonite and appropriate amount of Kan Fu Xin fluid into a paste. Then contained in the mouth for 5 minutes before each radiotherapy and before going to bed. We observed the degree of radiation-induced oral mucositis damage, the degree of oral radiation pain, the completion time of radiotherapy and recovery, etc. Results We found that the experimental group had a late onset of radiation-induced oral mucositis and a shorter recovery time than the control group （P < 0.05）. At the 3rd and 4th week of radiotherapy, the RTOM of the experimental group was mainly mild to moderate, and the control group was mainly moderate and severe. At the 5th and 6th week, the RTOM of the experimental group was mainly moderate, and the control group was mainly severe. At the 3rd to 6th week, there was a statistically significant difference in the incidence of RTOM between the two groups （P < 0.01）. The average radiotherapy time of the experimental group was less than that of the control group, and the difference was statistically significant （P < 0.05）. Conclusion Kan Fun Xin combined Montmorillonite can significantly reduce the symptoms of patients with radioactive oral mucositis, ensure that radiotherapy is completed on time, and can be widely used in clinical. -
Key words:
- Radiation-induced oral mucositis /
- Radiotherapy /
- Kan Fu Xin /
- Montmorillonite
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表 1 头颈部肿瘤放疗患者的一般资料（n = 138）
Table 1. General information on patients undergoing radiotherapy for head and neck tumor （n = 138）
一般资料 试验组 对照组 性别（n） 男 48 45 女 21 24 年龄（岁） 51.04 ± 3.66 50.47 ± 5 KPS评分（分） 89.53 ± 11.68 91.02 ± 14.23 临床分期（n） Ⅱ期 11 13 Ⅲ期 31 33 Ⅳ期 27 23 放疗剂量（Gy） 64.56 ± 3.48 63.97 ± 2.86 
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表 2 2组患者RTOM发生时间、恢复时间比较[（
$ \bar x \pm s$ ），d]Table 2. Comparison of RTOM occurrence time and recovery time between the two groups [（
$\bar x \pm s $ ），d]时间指标 试验组 对照组 t P RTOM出现时间 16.95 ± 4.23 11.37 ± 6.19 11.29 0.0165 RTOM恢复时间 20.45 ± 6.64 28.27 ± 7.41 18.76 0.000
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表 3 2组患者放射性口腔黏膜炎反应程度的比较[n（%）]
Table 3. Comparison of reaction degree of radiation-induced oral mucositis between the two groups [n（%）]
时间 试验组 对照组 轻度 中度 重度 轻度 重度 重度 t P 第2周 7（87.5） 1（12.5） 0 18（81.8） 3（13.6） 1（4.6） 1.259 0.137 第3周 38（55.1）* 30（43.5）* 1（1.4）* 19（27.5） 37（53.6） 13（18.9） 3.824 < 0.01 第4周 27（38.5）* 39（55.8）* 3（5.7）* 12（16.9） 29（41.9） 28（41.2） 3.165 < 0.01 第5周 15（21.7）* 43（61.8）* 11（16.5）* 6（8.9） 27（39.2） 38（54.8） 3.743 < 0.01 第6周 7（9.3）* 47（68.0）* 16（22.7）* 1（1.4） 26（37.7） 42（60.9） 4.015 < 0.01 与对照组比较，*P < 0.01。
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表 4 2组患者的NRS疼痛评分比较[（
$\bar x \pm s $ ），分]Table 4. Comparison of pain scores with NRS between the two groups [（
$\bar x \pm s $ ），points]NRS评分 试验组 对照组 t P 第2周 0.31 ± 0.46 0.50 ± 0.53 1.578 0.219 第3周 2.48 ± 1.31 4.35 ± 1.39 2.624 0.0358 第4周 3.54 ± 2.41 5.12 ± 2.39 4.775 < 0.001 第5周 4.18 ± 2.50 5.82 ± 2.18 4.921 < 0.001 第6周 4.17 ± 2.16 5.91 ± 2.40 4.865 < 0.001
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