虎黄烧伤搽剂防治鼻咽癌患者放射性皮炎的临床观察
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篇名: 虎黄烧伤搽剂防治鼻咽癌患者放射性皮炎的临床观察
TITLE: Clinical Observation of Huhuang Burn Liniment on the Prevention and Treatment of Radiation Dermatitis of Nasopharyngeal Carcinoma Patients
摘要: 目的:观察虎黄烧伤搽剂防治鼻咽癌患者放射性皮炎的效果和安全性。方法:选择2018年8月-2020年2月我院收治的鼻咽癌患者129例,按放疗先后顺序编号,单号患者为观察组(65例)、双号患者为对照组(64例)。两组患者均行常规放疗和皮肤护理;对照组患者在放疗期间于照射野皮肤均匀涂抹湿润烧伤膏,观察组患者涂抹虎黄烧伤搽剂;涂抹范围均需超过照射野外边缘1cm;每日涂药3次,直至第1阶段放疗(共放疗33~38次)结束。观察两组患者的皮损情况,记录皮损出现时间、皮损痊愈时间和放射性皮炎美国肿瘤放射治疗协作组(RTOG)评分、数字疼痛评分(NRS);分别于放疗0、15、30次时检测两组患者的血清细胞因子[肿瘤坏死因子α、白细胞介素6(IL-6)、IL-8、IL-10]水平;记录两组患者治疗过程中不良反应的发生情况。结果:观察组患者的皮损出现时间显著长于对照组,皮损痊愈时间显著短于对照组(P<0.01);两组患者放射性皮炎RTOG分级均以1级最多,未见3、4级,各分级患者比例比较差异无统计学意义(P>0.05);对照组和观察组患者最高NRS评分分别为3、2分,两组0~3分患者比例比较,差异有统计学意义(P<0.05)。放疗0次时,两组患者血清细胞因子水平比较,差异均无统计学意义(P>0.05);放疗15次时,两组患者细胞因子水平均较放疗前显著升高,但观察组显著低于同期对照组(P<0.05或P<0.01);放疗30次时,两组患者细胞因子水平均较放疗15次时显著降低,且观察组显著低于同期对照组(P<0.05或P<0.01),而对照组TNF-α、IL-6、IL-10水平以及观察组IL-6水平均显著高于同组放疗0次时(P<0.05或P<0.01)。两组患者治疗过程中均未出现过敏、皮疹、涂抹部位感染等不良反应。结论:黄虎烧伤搽剂对鼻咽癌患者放射性皮炎具有一定的防治作用,可延缓皮损发生并缩短皮损痊愈时间,降低患者疼痛感以及血清细胞因子水平,且安全性较好。
ABSTRACT: OBJECTIVE:To observe therapeutic efficacy and safe ty of Huhuang burn liniment on the prevention and treatment of radiation dermatitis patients with nasopharyngeal carcinoma (NPC). METHODS :Totally 129 NPC patients were collected from our hospital during Aug. 2018-Feb. 2020. They were numbered according to the order of radiotherapy ,the ones with odd number were included into observation group (65 cases)and the ones with even number into control group (64 cases). Both groups received routine radiotherapy and skin nursing. Control group were evenly smeared with Shirun shaoshang cream in the radiation field during radiotherapy ,and observation group were smeared with Huhuang burn liniment. The smearing area should be 1 cm beyond the edge of radiation field ,3 times a day until the end of stage 1 radiotherapy(33-38 times in total ). The skin lesions of the two groups were observed ;the appearance time and healing time of skin lesion ,RTOG score and NRS score were recorded. The levels of serum cytokines (TNF-α,IL-6,IL-8 and IL- 10)were detected in 2 groups at 0,15th and 30th time of radiotherapy. The occurrence of ADR was recorded in 2 groups during treatment. RESULTS :The appearance time of skin lesion in observation group was significantly longer than control group ;the healing time of skin lesion in observation group was significantly shorter than control group (P<0.01). RTOG grading of radiodermatitis in the two groups was mainly grade 1,but no grade 3 or 4 was found. There was no significant difference in the proportion of patients with differen RTOG grades (P>0.05). The highest NRS score of control group and observation group were 3 and 2 points respectively ,and the proportions of patients with 0-3 points in the two groups were statistically significant (P<0.05). There was no significant difference in serum cytokine levels between @qq.com 2 groups at 0 time of radiotherapy (P>0.05). The serum cytokine levels of 2 groups were increased significantly at 15th @qq.com time of radiotherapy , but t he observation group was significantly lower than control group at the same period (P<0.05 or P<0.01). At 30th time of radiotherapy ,the cytokine levels of 2 groups decreased significantly ,compared with 15th time of radiotherapy ,the observation group was significantly lower than the control group at the same period (P<0.05 or P<0.01);the levels of TNF-α,IL-6 and IL- 10 in control group as well as the level of IL- 6 in observation group were significantly higher than the same group at 0 time of radiotherapy (P<0.05 or P<0.01). There was no ADR such as allergy ,rash,smear site infection in the two groups during the treatment. CONCLUSIONS :Huhuang burn liniment has a good effect of preventing and treating radiation dermatitis of NPC patients ,delays the occurrence of skin lesion,shortens the healing time of skin lesion ,relieves pain and reduces the level of serum cytokines with good safety.
期刊: 2020年第31卷第17期
作者: 杜江蓉,廖玉芳,李飞
AUTHORS: DU Jiangrong ,LIAO Yufang ,LI Fei
关键字: 鼻咽癌;放射性皮炎;虎黄烧伤搽剂;疗效;安全性
KEYWORDS: Nasopharyngeal carcinoma ;Radiation dermatitis ;Huhuang burn liniment ;Therapeutic efficacy ;Safety
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