加減黃芪防己湯在喉癌術(shù)后放療引起的遲發(fā)性淋巴水腫中的應(yīng)用
發(fā)布時(shí)間:2018-01-22 08:10
本文關(guān)鍵詞: 喉癌 黃芪防己湯 放療 水腫 出處:《中國(guó)中西醫(yī)結(jié)合雜志》2017年10期 論文類型:期刊論文
【摘要】:目的探討加減黃芪防己湯在喉癌術(shù)后局部放療引起的遲發(fā)性淋巴水腫治療中的效果。方法將60例喉癌手術(shù)后放療患者分為中藥治療組和對(duì)照組,每組30例,每組包括20例部分喉切除及10例全喉切除病例,對(duì)照組中有13例行頸淋巴結(jié)清掃,術(shù)后僅予常規(guī)調(diào)強(qiáng)放療。中藥治療組有16例行頸淋巴結(jié)清掃,術(shù)后行調(diào)強(qiáng)放療同時(shí)給予黃芪防己湯加減,每日1劑,分2次口服,中藥療程為10周。放療結(jié)束1個(gè)月后,利用改良Miller和LENT-SOMA評(píng)分系統(tǒng)分別對(duì)各組放療引起的喉及頸部的遲發(fā)性淋巴水腫進(jìn)行評(píng)估,采用視覺量表(VAS)對(duì)患者的生活質(zhì)量進(jìn)行評(píng)估。結(jié)果與對(duì)照組比較,中藥治療組喉及頸部遲發(fā)性淋巴水腫的反應(yīng)分級(jí)明顯降低(P0.01,P0.05),VAS分值亦降低(P0.01)。結(jié)論加減黃芪防己湯能有效地預(yù)防和減輕放療引起遲發(fā)性淋巴水腫反應(yīng)。
[Abstract]:Objective to investigate the effect of Astragalus Fangji decoction in the treatment of delayed lymphedema caused by postoperative local radiotherapy for laryngeal carcinoma. Methods 60 patients with laryngeal carcinoma treated by radiotherapy after operation were divided into traditional Chinese medicine treatment group and control group with 30 cases in each group. Each group consisted of 20 cases of partial laryngectomy and 10 cases of total laryngectomy. In the control group, 13 cases underwent neck lymph node dissection, only routine intensity modulated radiotherapy was given after operation, and 16 cases were treated with traditional Chinese medicine treatment group. After operation, the patients were treated with intensity modulated radiotherapy (IMRT) at the same time as Huangqi Fangji decoction, 1 dose per day, divided into 2 oral doses, the course of treatment of traditional Chinese medicine was 10 weeks, and one month after the end of radiotherapy. Delayed lymphedema of larynx and neck were evaluated by modified Miller and LENT-SOMA scoring system. Visual scale was used to evaluate the quality of life of the patients. Results compared with the control group, the response grade of larynx and neck delayed lymphedema in the Chinese medicine treatment group was significantly lower than that in the control group (P0.01). Conclusion the addition and subtraction of Huangqi Fangji decoction can effectively prevent and reduce the delayed lymphedema induced by radiotherapy.
【作者單位】: 江蘇省蘇州市蘇州大學(xué)附屬第一醫(yī)院耳鼻咽喉科;江蘇省蘇州市蘇州大學(xué)附屬第一醫(yī)院中醫(yī)科;
【分類號(hào)】:R739.65
【正文快照】: 對(duì)于喉癌術(shù)后放療,喉及頸部淋巴水腫是最常見的急性或遲發(fā)放療反應(yīng)。臨床醫(yī)生常用腎上腺皮質(zhì)激素、利尿劑、β-七葉皂苷鈉等處理水腫,這些藥物都只能起短暫的作用,對(duì)于緩解由于組織纖維化導(dǎo)致的水腫療效欠佳[1]。很多學(xué)者針對(duì)減少放療的毒副作用做了大量的研究,包括采用各種放,
本文編號(hào):1454176
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