本文選題：鼻咽癌 + 放射治療　； 參考：《廣州中醫(yī)藥大學(xué)》2011年碩士論文

【摘要】：背景及目的 口干燥癥是鼻咽癌放療后最常見的后遺癥之一,嚴(yán)重影響患者的生存質(zhì)量。本研究旨在探討鼻咽癌放療后口干燥癥的嚴(yán)重程度及其對日常生活的影響,觀察增液湯加味對鼻咽癌放療所致的唾液腺損傷的保護(hù)作用,客觀評價中醫(yī)藥干預(yù)鼻咽癌放療后副反應(yīng)口干燥癥的影響。 方法 選擇我院2009年12月-2010年12月收治的65例確診為鼻咽癌,并進(jìn)行首次放療的患者,隨機分成兩組,其中治療組(中藥+放療)34例,對照組(單純放療)31例。最終剔除5例,有效病例數(shù)60例,其中治療組33例,對照組27例。于DT 0、10、20、30、40、50、60Gy及放療結(jié)束時,分別記錄口腔黏膜情況,檢測唾液PH值；放療前后行面對面訪談式的口干問卷調(diào)查及口干程度VAS評分,并行SPECT核素動態(tài)顯像定量分析,利用SPECT機的R.O. Isequence軟件對放療前后腮腺核素動態(tài)顯像后的UI、El值數(shù)據(jù)分析,客觀評價放療前后鼻咽癌患者唾液腺功能。 結(jié)果 所有患者在放療中均出現(xiàn)放射性口腔黏膜反應(yīng),其嚴(yán)重程度與放射劑量相關(guān)；治療組放射性口腔黏膜反應(yīng)輕于對照組(P0.01)。在DT≤30Gy時,Ⅰ度、Ⅱ度黏膜反應(yīng)組間比較有顯著性差異(P0.01)。DT40Gy時,Ⅲ度黏膜反應(yīng)組間無顯著差異；在DT 70Gy時,Ⅱ度、Ⅳ度黏膜反應(yīng)組間比較有顯著性差異(P0.01)。隨著劑量的增加,SPECT核素動態(tài)顯像定量顯示兩組前后腮腺功能攝取-排泌功能均較前下降,以排泌功能下降為主；治療組腮腺UI、EI較放療前分別下降29.1%、44.3%；對照組腮腺UI、E1分別較放療前分別下降44.3%、74.1%；但治療組下降的程度輕于對照組。放療后二組口腔pH值均低于正常范圍(6.5-7),口腔pH的異常與急性口腔黏膜反應(yīng)發(fā)生有相關(guān)性；60例患者均有不同程度的口干,二組各有54.6%、77.9%發(fā)生中到重度口干。治療組與對照組對口干VAS評分有顯著差異(P0.01)。 結(jié)論 鼻咽癌患者放療后均有不同程度的口干；鼻咽癌放療后口干燥癥對患者講話、咀嚼、吞咽、睡眠有嚴(yán)重影響,患牙病的幾率增加。SPECT核素動態(tài)顯像定量分析方法是評價鼻咽癌患者放療后唾液腺功能受損程度的敏感、實用的方法,腮腺功能損傷以排泌功能受損為主。增液湯加味含漱配合內(nèi)服可推遲放射性口腔黏膜反應(yīng)出現(xiàn)的時間,減輕放療反應(yīng)后口干癥狀,提高患者的生存質(zhì)量,具有一定的臨床推廣應(yīng)用價值。
[Abstract]:Background and purpose Xerostomia is one of the most common sequelae of nasopharyngeal carcinoma after radiotherapy, which seriously affects the quality of life of patients. The purpose of this study was to investigate the severity of xerostomia after radiotherapy for nasopharyngeal carcinoma and its influence on daily life, and to observe the protective effect of Zengye decoction on salivary gland injury induced by radiotherapy for nasopharyngeal carcinoma. Objective to evaluate the effect of traditional Chinese medicine (TCM) on desiccation of side reaction after radiotherapy for nasopharyngeal carcinoma (NPC). Method From December 2009 to December 2010, 65 patients with nasopharyngeal carcinoma (NPC) were randomly divided into two groups: treatment group (34 cases) and control group (31 cases). Finally, 5 cases were eliminated, 60 cases were effective, including 33 cases in treatment group and 27 cases in control group. Oral mucosa was recorded and saliva PH was detected at the end of radiotherapy, oral dry questionnaire and VAS score were performed before and after radiotherapy, and quantitative analysis of SPECT radionuclide dynamic imaging was performed before and after radiotherapy. The function of salivary gland in patients with nasopharyngeal carcinoma (NPC) was evaluated objectively by using the software R.O. Isequence of SPECT machine to analyze the UIN El value of parotid nuclide dynamic imaging before and after radiotherapy. Result Radiation oral mucosal reaction was found in all patients, and the severity was correlated with the dose of radiation, and the radiation oral mucosal reaction in the treatment group was less than that in the control group (P 0.01). When DT 鈮，

本文編號：1869752