【摘要】：目的:探究中藥?kù)F化吸入及鼻腔中藥灌洗法給藥對(duì)鼻咽癌放療后鼻腔、鼻咽組織的修復(fù)作用,為臨床醫(yī)生選擇給藥途徑提供理論依據(jù)。方法:將80只豚鼠分為對(duì)照組、單純照射組、鼻腔中藥灌洗組、中藥?kù)F化吸入組,每組20只。除對(duì)照組外的豚鼠無(wú)麻醉下固定器固定,用Co-60治療機(jī)產(chǎn)生的射線作鼻部照射,照射劑量30Gy,每次300c Gy,每周5次,共照射10次。照射開(kāi)始當(dāng)天即開(kāi)始給藥,鼻腔中藥灌洗組用桂林醫(yī)學(xué)院藥學(xué)院提取的中藥灌洗液對(duì)豚鼠鼻腔每天灌洗1次,共灌洗4周;中藥?kù)F化吸入組用桂林醫(yī)學(xué)院藥學(xué)院提取的中藥?kù)F化吸入液對(duì)豚鼠霧化吸入,每天1次,共霧化吸入4周;對(duì)照組及單純照射組不用藥。采集照射后第1天、2周、4周、8周、12周頸總動(dòng)脈處血液行肝腎功能檢測(cè),同時(shí)取鼻咽部黏膜HE染色后行光學(xué)顯微鏡觀察細(xì)胞形態(tài),原位免疫組織化學(xué)法(TUNEL法)檢測(cè)藥物對(duì)黏膜組織內(nèi)細(xì)胞凋亡的影響。結(jié)果:肝腎功能檢測(cè)發(fā)現(xiàn)對(duì)照組、單純照射組、鼻腔中藥灌洗組及中藥?kù)F化吸入組ALT、AST、AST/ALT、BUN、Cr水平無(wú)統(tǒng)計(jì)學(xué)差異(P0.05);HE染色發(fā)現(xiàn)除對(duì)照組外,其余3組均呈不同程度的炎癥狀態(tài),單純照射組HE染色顯示炎癥細(xì)胞數(shù)目最多,而鼻腔中藥灌洗組最少;采用TUNEL法檢測(cè)藥物對(duì)黏膜組織內(nèi)細(xì)胞凋亡的影響,發(fā)現(xiàn)除對(duì)照組外均出現(xiàn)TUNEL陽(yáng)性細(xì)胞,其中鼻腔中藥灌洗組TUNEL陽(yáng)性細(xì)胞數(shù)最少,其次為中藥?kù)F化吸入組。結(jié)論:鼻腔灌洗法給藥途徑較中藥?kù)F化吸入法治療對(duì)于鼻咽癌放療后損傷的鼻黏膜修復(fù)作用更佳,能夠促進(jìn)炎癥的消退,抑制細(xì)菌的生長(zhǎng)。
[Abstract]:Objective: to investigate the effect of Chinese medicine atomization inhalation and nasal Chinese medicine lavage on the repair of nasopharyngeal carcinoma (NPC) after radiotherapy, and to provide a theoretical basis for clinicians to choose the route of administration. Methods: 80 guinea pigs were divided into control group, simple irradiation group, nasal cavity Chinese medicine lavage group, Chinese medicine atomization inhalation group, 20 guinea pigs in each group. Except for the control group, the guinea pigs were fixed without anesthesia. The irradiation dose was 30 Gy with the irradiation dose of 30 Gy, 5 times a week with 300c Gy, 10 times a week. The nasal cavity Chinese medicine lavage group was perfused once a day for 4 weeks with the Chinese medicine lavage liquid extracted from the college of medicine of Guilin Medical College. The Chinese medicine atomization inhalation group used the Chinese medicine atomization inhalation liquid extracted from Guilin Medical College of Pharmacology to the guinea pig atomization inhalation once a day for a total of 4 weeks; the control group and the simple irradiation group did not use drugs. The liver and kidney function were measured at the common carotid artery on day 1, day 2, week 4, week 8 and week 12 after irradiation. At the same time, the nasopharyngeal mucosa was stained with HE and the morphology of the cells was observed by optical microscope. In situ immunohistochemical method (TUNEL) was used to detect the effect of drugs on apoptosis in mucosal tissue. Results: the levels of ALT,AST,AST/ALT,BUN,Cr in the control group, the irradiation group, the nasal cavity Chinese medicine lavage group and the Chinese medicine atomization inhalation group were not significantly different from those in the control group (P0.05); HE staining showed that the other three groups showed different degree of inflammation except the control group. HE staining showed that the number of inflammatory cells was the highest in the irradiation group, while the number of the inflammatory cells was the least in the nasal cavity Chinese medicine lavage group, the effect of the drugs on the apoptosis of mucosal tissue was detected by TUNEL method, and TUNEL positive cells were found in all the cells except the control group. The number of TUNEL positive cells in nasal cavity Chinese medicine lavage group was the least, followed by traditional Chinese medicine atomization inhalation group. Conclusion: nasal lavage is more effective than traditional Chinese medicine atomization inhalation in repairing nasopharyngeal carcinoma (NPC) after radiotherapy. It can promote the regression of inflammation and inhibit the growth of bacteria.
【作者單位】： 廣西壯族自治區(qū)南溪山醫(yī)院;廣西中醫(yī)藥大學(xué)附屬瑞康醫(yī)院;
【基金】：廣西壯族自治區(qū)科技廳課題:鼻咽鼻腔放療后局部組織影響動(dòng)物模型構(gòu)建與中藥局部干預(yù)及藥效研究(桂科攻13349008)
【分類號(hào)】：R273;R-332

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