Study Of Acute Radiation Oral Mucositis Of Yin Deficiency Inner Heat Treated By Nourishing Yin And Clearing Heat

ObjectivesTo observe the change about the degree of injuried oral mucous and epidermal growth factor(EGF)in saliva,and to evaluate the quality of life(QOL)by (European Organization for Researeh and Treatment of Caneer,EORTC)QLQ-C30 with nasopharyngeal carcinoma patients who had acute radiation oral mucositis of yin deficiency inner heat treated by nourishing yin and clearing heat therapy.Methods60 cases of NPC treated with radiotherapy for the first time were assigned into two groups:treatment group(n=31)and control group(n=29),according to the desire of patients.The treatment group was treated with the method of nourishing yin and clearing heat therapy,and the control group was treated with standard medical therapy.The injuried oral mucous of patients at DT 0, 20,30,40,50,60Gy as well as at the end of radiation therapy,was observed. Moreover,the EGF in saliva of patients at DT 0,40 and 70Gy was detected by ELISA method,meanwhile the quality of life of patients by EORTC QLQ-C30 before and after the radiation therapy was evaluated.ResultsIn the process of radiotherapy,all cases occured the acute radiation oral mucositis.The condition of injuried oral mucous of treatment group was better than that of control group(P＜0.01).At DT 30Gy,bothⅠandⅡdegree of injuried oral mucous between two groups was statistically significant(P＜0.01). And bothⅡandⅢdegree of injuried oral mucous was statistically significant(P＜0.01)at DT 70Gy.With the dose increasing:,the EGF in saliva decreased.At 40Gy the EGF decreased significantly while the EGF decreasing to the minimum at 70Gy,indicating statistical difference between two groups (P＜0.01).The comparison of QLQ-C30 after radiotherapy between two groups showed that the domain of global health status of treatment was superior to control group (P＜0.01).In domains of emotional functioning and social functioning the treatment group was better than the control group(P＜0.01)While in domains of fatigue,nausea and vomiting,appetite loss,diarrhea,the scores of treatment group were higher than the control group(P＜0.01).Also in domain of pain,the treatment group was lighter than the control group(P＜0.05). It revealed that the QOL of treatment group was improved and was superior to control group.Conclusions1.The therapy of nourishing yin and clearing heat postponed the acute radiation oral mucositis,lessened the side effect caused by radiotherapy actually.Furthermore,this therapy has such pratical potentiality to promote.2.The EGF in saliva was increased after the therapy of nourishing yin and clearing heat,while the injuried of oral mucous decreased.Because EGF was originated from parotid gland and submandibular gland,it was assumed to protect the salivary gland among the radioactive area by therapy of nourishing yin and clearing heat.3.The scores both in symptom domain as fatigue,pain,nausea and vomiting, insomnia,appetite loss,as well as function domain as emotional functioning, social functioning of treatment group were higher than that of control group. It showed the effect of therapy of nourishing yin and clearing heat on the QOL of patients was better than that of modern medical therapy.