| The paper is divided into two parts.The first part is the literature review.The review of the literature is a total of 2 articles,reviewing the progress in the treatment of Radiation Inflammatory Oral Mucositis(RIOM)both at China and abroad in recent years.The first review introduces Western medicine's acknowledge of RIOM and its treatment progress,including:the disease-related factors of RIOM,pathogenesis,grading standards,and treatment progress.Western medicine currently treats RIOM mainly about symptomatic treatment.The treatment methods include physical therapy,chemical treatment,and biological agents.Clinically reported physical therapies include oral ice,low-energy laser irradiation,and short-wave UV radiation.The types of instruments and equipment required for irradiation therapy are different,and it is difficult to establish an objective evaluation standard.Further more the treatment can only be carried out in hospitals,and the practical application is limited.Chemotherapy is mainly based on drugs,including kangfuxin liquid,vitamin B12,dubellel iquid,but all of these treatment are not outstanding effect.In recent years,clinical reports on the use of biological agents to treat radioactive stomatitis have increased,such asdeproteinized extract of calf blood,rhIL-11,GM-CSF and so on.However,biological agents which are expensive,have many related side effects,and have low cost performance.In short,in the treatment of radioactive stomatitis,there is no standard guideline recommended by the international guidelines,and clinically effective drugs are lacking in efficacy,ease of use,safety,and cost-effectiveness.The second review presents the acknowledge and treatment of RIOM in traditional Chinese medicine(TCM).A systematic review was conducted on six aspects of TCM etiology and pathogenesis,TCM syndrome types,rules of treatment,medication use,internal treatment in TCM,and external treatment in TCM for RIOM.Chinese medicine believes that the basic pathogenesis of radioactive stomatitis is "fire and toxic injuring yin".Clinically it is characterized by dry mouth,redness,pain,and even local symptoms of tongue sores.Systemic symptoms can be seen thin,difficult to eat,red tongue,and moss.thin yellow or less moss,pulse breakdown and other yin deficiency syndrome performance.The governing methods are mainly detoxification,nourishing yin,and promoting blood circulation.In the aspect of internal treatment of traditional Chinese medicine,various Chinese medicine doctors choose to use classical traditional Chinese medicine prescriptions to treat RIOM according to the actual clinical conditions,such as Liange San,Yang Yin Qing Fei Tang,and other self-made decotions.The clinical reports of external treatment of RIOM by TCM are numerous and flexible.Such as through acupuncture.There are also doctors using self-made oil coating,homemade gargle with external hemorrhoids to treat the disease.In short,the external treatment of traditional Chinese medicine fully embodies the traditional advantages of "simple,convenient,effective,and inexpensive" and is worthy of clinical promotion.The second part of the paper is clinical research.The clinical study examined the clinical effect of Kuiyang oil in the treatment of RIOM through a multi-center,non-randomized controlled study.Objective:The object of the study is to observe the clinical efficacy and safety of Kuiyang oil in the treatment of RIOM.Hope to improve the quality of life of patients and to maintain the normal radiotherapy by alleviating the side effects of radiotherapy,and to provide a clinically effective method by external treatment of TCM.Methods:Through multi-center,non-randomized study methods,48 patients were included in the diagnosis of acute radiation stomatitis during radiotherapy or after radiotherapy(within 6 months),24 in the observation group and 24 in the control group.The experimental group was treated with Kuiyang oil;in the control group,Kangfuxin solution was used,or Kangxinxin combined with other conventional treatment for radioactive stomatitis(vitamin B12,rhGM-CSF,diphenhydramine cream,and traditional Chinese medicine)could be used.The patients were followed up for 1 time and the treatment effect was recorded.Medication and observation time are 2 weeks.(Each week is one course of treatment.If the patient's RIOM is cured in the first week,the drug can be discontinued in the second week.)The patients were followed up for each treatment course and the pain scores and pain relief rates were observed after treatment.The grade change of RIOM,treatment efficiency,treatment onset time,incidence of secondary oral infections,patient satisfaction,drug safety,and then analyzed and compared the differences between the two groups.Case grouping,data management,and statistical analysis all use SPSS 20.0 software.All statistical tests use two-sided tests,with P=0.1 as the remaining role of the test standard,and the rest are P<0.05 for the difference was statistically significant.Results:(1)Completion situation:48 patients were enrolled,46 patients were followed up,22 patients were followed up in the observation group,2 patients were detached,and the expulsion rate was 8.33%.Totally 22 patients were included in the statistics(When calculating the secondary OM infection rate,24 cases were all included in the statistics).The control group completed 24 cases and included statistics in 24 cases.(2)Main observation indexes:After treatment,the RIOM grades of the two groups were compared:after two weeks of treatment,the RIOM grade of the observation group was mainly grade I,accounting for 86.33%,and the control group was mainly ?,?,accounting for 70.83%.The difference was statistically significant(P=0.007).Treatment efficiency:The overall effective rate was 94.45%in the observation group,and 70.83%in the control group.The difference between the two groups was statistically significant(P=0.049).Comparison of NRS pain scores after treatment between two groups:After two weeks of treatment,most patients in the observation group were painless and mild pain,accounting for 87%;the majority of the control group were mild pain and moderate pain,accounting for 79.17%.Differences in pain scores between the two groups after treatment were statistically significant,P = 0.001.Pain remission rate:The overall efficiency of the observation group was 100%,and the overall efficiency of the control group was 84.0%.The chi-square test was used,P=0.213,and the difference was not statistically significant.onset time:from the beginning of the group to the end of treatment,the average onset time in the observation group was 5.18 days;the average onset time in the control group was 7.91 days,and the difference in onset time was statistically significant(P<0.05).(3)Secondary observations:Patient satisfaction:A total of 18 patients in the observation group were satisfied with the treatment effect,and the overall satisfaction rate was 81.2%;13 patients in the control group were satisfied with the treatment effect,and the overall satisfaction was 54.2%.The difference was statistically significant(P<0.05).secondary oral infection rate:the observation group secondary oral infection rate was 8.33%.There was no secondary oral infection in the control group.Thus,the incidence of secondary oral infection in the observation group was higher than that in the control group.Comparison of safety:No allergic reactions and other adverse reactions occurred during treatment in both groups of patients. |
PDF Full Text Request