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目的观察重组人表皮生长因子凝胶联合中药治疗放射性口腔黏膜炎的疗效,为临床寻找一种安全、有效、经济的治疗方案。方法将106例头颈部恶性肿瘤患者随机分为对照组(53例)和观察组(53例)。对照组仅采用对症治疗,观察组在常规对症治疗基础上,从放疗开始应用重组人表皮生长因子凝胶和自制中药,至患者口腔黏膜损伤恢复正常。采用连续放疗,每次1.82~2.18 Gy,每日1次,每周5次,放疗总剂量DT=60~71.96 Gy,放疗方式为三维适形放疗或者调强放疗。结果观察组较对照组放射性口腔黏膜炎发生时间晚、恢复时间短,两者比较差异均有统计学意义(P<0.05)。两组中重度放射性口腔黏膜炎发生率分别为观察组60.4%、对照组94.4%,两组间差异有统计学意义(P<0.05)。观察组与对照组平均放疗时间分别为(48.61±3.57)d和(57.21±2.76)d,差异有统计学意义(P<0.05)。结论重组人表皮生长因子凝胶联合中药能明显减轻发生放射性口腔黏膜炎患者的症状,保证了放疗按时完成,可广泛应用于临床。
Objective To observe the efficacy of recombinant human epidermal growth factor gel combined with traditional Chinese medicine in the treatment of radiation-induced oral mucositis, and to find a safe, effective and economical treatment plan for clinical practice. Methods 106 cases of head and neck cancer were randomly divided into control group (53 cases) and observation group (53 cases). In the control group, symptomatic treatment was used only. The observation group was treated with recombinant human epidermal growth factor gel and homemade Chinese medicine on the basis of routine symptomatic treatment, and the oral mucosal injury of the observation group returned to normal. The patients were treated with continuous radiotherapy, 1.82 ~ 2.18 Gy each time, once a day, 5 times a week. The total dose of DT was 60 ~ 71.96 Gy. The radiotherapy mode was 3D conformal radiotherapy or IMRT. Results Compared with the control group, the incidence of radiation-induced oral mucositis was shorter and the recovery time was shorter. The difference between the two groups was statistically significant (P <0.05). The incidence of moderate to severe radiation-induced oral mucositis in the two groups was 60.4% in the observation group and 94.4% in the control group, respectively, with significant difference between the two groups (P <0.05). The average radiotherapy time in observation group and control group were (48.61 ± 3.57) d and (57.21 ± 2.76) d, respectively, with significant difference (P <0.05). Conclusion Recombinant human epidermal growth factor gel combined with traditional Chinese medicine can significantly reduce the occurrence of radiation-induced oral mucositis in patients with symptoms and ensure the timely completion of radiotherapy can be widely used in clinical.