Clinical Study Of Yinhe Gargle In Preventing Oral Mucositis In Patients With Nasopharyngeal Carcinoma During Concurrent Chemoradiotherapy

ObjectiveThrough guiding the patients with nasopHaryngeal carcinoma(NPC)to use the Yinhe Gargle regularly during the concurrent chemoradiotherapy(CCRT).To provide theoretical basis and guidance for clinical treatment and nursing of concurrent chemoradiotherapy-induced oral mucositis.Analyzing the the degree of oral mucositis,the pH value of oral saliva,the Water Consumption and numerical rating scale of pain after intervention.Observe whether the Yinhe Gargle can effectively prevent the toxicity of oral mucosa during CCRT or reduce the occurrence of concurrent chemoradio therapy(CCRT)-related oral ulcers.Explore an effective way to prevent CCRT oral mucositis in patients with nasopharyngeal carcinoma(NPC),alleviate the pain of patients during the treatment.MethodsPatients with nasopharyngeal carcinoma(NPC)would accept concurrent chemoradiotherapy(CCRT)were selected from January 2018 to October 2018 in the department of radiotherapy in a Third Class A Hospital in Guangdong province after the examination by the Ethics Committee.61 patients were included according to specific exclusion criteria.The patients were randomly divided into two groups:observation group(n=31)and control group(n=30).The patients in the two groups were given routine basic nursing treatment,diet guidance and health education including diet,medication,oral cleaning and hygiene,nasal lavage before,during and after treatment days.Patients in the observation group were given 30ml gargle at least 5 minutes when awake,before going to bed and after three meals respectively.According the evaluation method of oral mucositis recommended by(World Health Organization,WHO)in 1995,Numerical Rating scale(NRS),the mucositis degree and pain score of patients were recoded at different stages of treatment(radiation dose lOGy,20Gy,40Gy,60Gy,1st,2nd,4th,6th chemotherapy),to evaluate the efficacy of prevention and treatment of oral mucositis with silver-mint gargle on the patients.At the same time,the pH value of saliva and drinking volume were analysized and compared,to assess the effects of silver-lotus gargle on oral pH and drinking volume.SPSS19.0 statistical software was used for statistical analysis,there was significant difference between the two groups(P<0.05).Result1.The incidence of oral mucositis and its degree of response and pain score were compared between the two groups:(1)the incidence of oral mucositis in the observation group was lower than that in the control group,the difference was statistically significant(P<0.05);(3)In the course of CCRT(radiation dose 10Gy,20Gy,40Gy,60Gy,1st,2nd,4th,6th chemotherapy),the reaction degree of oral mucositis in the observation group was lighter than that in the control group(P<0.05).4 during the course of CCRT(20 Gy,40 Gy,60Gy,2nd,4th,6th chemotherapy),the pain degree of oral mucositis in the observation group was lighter than that in the control group.There was a significant difference in pain score between the two groups(P<0.05);2.Comparison of pH value of oral saliva between the two groups:(1)before CCRT,the pH value of oral saliva in the observation group was(7.02±0.32)and(7.04±2.54).There was no significant difference between the two groups(P>0.05).(2)With the prolongation of CCRT(radiation dose 20Gy,40Gy,60Gy,2nd,4th,6th chemotherapy),the pH value of oral saliva of the two groups decreased gradually.The pH value of oral saliva in the experimental groupwas higher than that in the control group(P<0.05),and there was a significant difference between the two groups(P<0.05);3.The water consumption of the two groups of NPC patients was compared with that of the control group before and after CCRT.The water consumption of the observation group was 761.67(134.98)ml and(831.29,143.43)ml before,and the difference between the two groups was not significant(P>0.05);in the course of CCRT treatment(radiation dose 20Gy,40Gy,CCRT 2nd,4th chemotherapy),the water consumption of the two groups increased gradually,the control group was higher than that of the observation group,and the observation group was higher than that of the control group at the time of 60 Gy(P<0.05).ConclusionYinhe gargle can effectively prevent and control oral mucosal reaction in patients with nasopharyngeal carcinoma treated with CCRT,and relieve the oral discomfort.The effective ingredients of Yinhe gargle can help oral anti-inflammatory,anti-inflammatory and analgesic,and maintain the stability of oral environment.It reduces the pain caused by mucosal reaction and contributes to the daily intake of water to improve the patient' s comfort.