摘要
目的研究中医辨证联合清创术治疗鼻咽癌放疗后鼻咽坏死的临床治疗效果。方法选取2016年1月—2019年10月该院收治的42例鼻咽癌放疗后鼻咽坏死患者,采用随机数值表法分为观察组和对照组各21例。对照组患者予清创术治疗,观察组在此基础上于入院后第1天至术后1个月加予中药辨证治疗。记录两组手术情况,并于患者治疗前后采用中医症状积分量表进行口干、倦怠乏力及食少纳呆积分计算,测定CD+4、CD+8、CD+4/CD+8水平。所有患者随访6个月,记录两组术后并发症发生情况及鼻咽创面愈合情况。结果两组术中出血量、鼻咽缺损直径比较差异无统计学意义(P<0.05)。观察组治疗后的口干、倦怠乏力及食少纳呆各方面中医证候积分较本组治疗前及对照组治疗后均明显下降(P<0.05)。观察组患者治疗后的CD+8水平与本组治疗前及对照组治疗后比较差异无统计学意义,但CD+4、CD+4/CD+8水平较本组治疗前及对照组治疗后均明显上升(P<0.05)。观察组鼻咽创面愈合情况明显优于对照组(P<0.05);观察组术后并发症发生率低于对照组,但组间差异无统计学意义(P>0.05)。结论中医辨证联合清创术治疗鼻咽癌放疗后鼻咽坏死能明显改善患者临床症状,提升患者免疫水平,且有利于降低鼻咽创面未愈合风险。
Objective To study the clinical curative effect of TCM syndrome differentiation combined with debridement on nasopharyngeal necrosis after nasopharyngeal carcinoma(NPC)radiotherapy.Methods Forty-two patients with nasopharyngeal necrosis after NPC radiotherapy who were admitted to the hospital from January 2016 to October 2019 were enrolled.They were divided into observation group and control group by random number table method,21 cases in each group.The control group was treated with debridement,while the observation group was treated with TCM syndrome differentiation from the first day after admission to the first month after surgery on the basis of the control group.The surgical situations in both groups were recorded.Before and after treatment,scores of dry mouth,burnout and fatigue,and anorexia were calculated by TCM symptoms scale.The levels of CD4+,CD8+and CD4+/CD8+were measured.All patients were followed up for 6 months to record postoperative complications and healing of nasopharyngeal wound in both groups.Results There were no significant differences in intraoperative blood loss or diameter of nasopharyngeal defects between the two groups(P<0.05).After treatment,scores of TCM symptoms(dry mouth,burnout and fatigue,anorexia)in the observation group were significantly lower than those before treatment and those in the control group(P<0.05).After treatment,there was no significant difference in CD8+level in the observation group compared with that before treatment,and between two groups.However,levels of CD4+and CD4+/CD8+in the observation group were significantly higher than those before treatment and those in the control group(P<0.05).The healing of nasopharyngeal wound in the observation group was significantly better than that in the control group(P<0.05).The incidence of postoperative complications in the observation group was lower than that in the control group.The difference was not statistically significant between the two groups(P>0.05).Conclusion TCM syndrome differentiation combined with debridement in the treatment of nasopharyngeal necrosis after NPC radiotherapy can significantly improve clinical symptoms and immune level of patients,which is beneficial to reduce the incidence of postoperative complications and non-healing risk of nasopharyngeal wound.
作者
王顺兰
王曦
李春桥
WANG Shunlan;WANG Xi;LI Chunqiao(Department of Otolaryngology,The First Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangzhou 510405,Guangdong,China)
出处
《辽宁中医杂志》
CAS
2021年第7期100-103,共4页
Liaoning Journal of Traditional Chinese Medicine
基金
国家自然科学基金(82071024)
广东省科技厅(2017ZC0156)
关键词
鼻咽癌
鼻咽坏死
放疗
中医辨证治疗
清创术
nasopharyngeal carcinoma
nasopharyngeal necrosis
radiotherapy
TCM syndrome differentiation
debridement
