摘要 目的：探讨扶正解毒方加减联合艾灸对鼻咽癌患者放化疗后口腔黏膜损伤及炎性反应的影响。方法：选取2016年1月至2017年10月梧州市红十字会医院收治的鼻咽癌患者105例为研究对象，所有患者均行放化疗治疗，之后按照治疗方法的不同分为中药+艾灸组、中药组与对照组，每组35例。观察3组患者临床疗效；比较3组患者放化疗后口腔黏膜损伤状况；检测并比较3组血清中炎性反应因子水平。结果：治疗后中药+艾灸组、中药组、对照组的总有效率分别为77.14%、61.76%、58.82%，3组间總有效率差异有统计学意义（P<0.05或P<0.01）；治疗后中药+艾灸组、中药组患者口腔内PH值及3组VAS评分较治疗前显著下降，且中药+艾灸组显著低于中药组与对照组（P<0.05或P<0.01）。治疗后3组血清中TGF-β1、IL-6、CRP水平均较治疗前显著下降，且中药+艾灸组显著低于中药组与对照组（P0.05）。结论：扶正解毒方加减联合艾灸可有效减轻鼻咽癌患者放化疗后口腔黏膜损伤，并控制炎性反应进展，提升整体疗效。
　　关键词 扶正解毒方加减；艾灸；鼻咽癌；放化疗；口腔黏膜损伤；炎性反应
　　Abstract Objective：To study the effects of Fuzheng Jiedu Decoction combined with moxibustion on oral mucosal injury and inflammation in patients with nasopharyngeal carcinoma after radiotherapy and chemotherapy.Methods：A total of 103 patients with nasopharyngeal carcinoma admitted to Wuzhou Red Cross Hospital from January 2016 to October 2017 were selected as the research objects.All patients were treated with radiotherapy and chemotherapy.Then they were divided into Chinese herbal medicine+moxibustion group，Chinese herbal medicine group and control group according to the different treatment methods，（35 vs 34 vs 34）.The clinical efficacy of 3 groups of patients was observed.The oral mucosal lesions after radiotherapy and chemotherapy were compared among 3 groups，and the levels of serum inflammatory factors were detected and compared among 3 groups.Results：After treatment，the total effective rates of Chinese herbal medicine+moxibustion group，Chinese herbal medicine group and control group were 77.89%，65.66% and 59.00% respectively.There were significant differences among 3 groups，and the total effective rate of Chinese herbal medicine+moxibustion group was higher than that of Chinese herbal medicine group and control group （P0.05）.Conclusion：Fuzheng Jiedu Decoction combined with moxibustion can effectively alleviate oral mucosal injury in patients with nasopharyngeal carcinoma after radiotherapy and chemotherapy，control the progress of inflammation，alleviate other adverse reactions，and enhance the overall efficacy.
　　Key Words Fuzheng Jiedu decoction； Moxibustion； Nasopharyngeal carcinoma； Radiotherapy and chemotherapy； Oral mucosa injury； Inflammation
　　中图分类号：R273；R245.81 文献标识码：A doi：10.3969/j.issn.1673-7202.2018.12.042
　　近年来，全世界范围内鼻咽癌的发病率逐渐升高，临床主要通过放化疗治疗鼻咽癌，但治疗过程中放射线无法避免地对患者口腔黏膜造成损伤，此外剧烈疼痛、进食困难等降低了患者在放射治疗中的依从性，因此临床治疗效果受到影响[1-2]。因此如何预防或减轻放化疗引起的口腔黏膜损伤，抑制口腔炎性反应成为临床治疗难点。中医认为正气虚则成岩，肝脾受损、营气内虚、痰瘀内积、邪盛渐起是鼻咽癌的发病机制[3]。放化疗引发的口腔黏膜损伤及炎性反应等属于“热毒”之邪，毒热之邪耗损阴津，进而导致气血、肌肤受损，扶正解毒方在扶正之余具有增效减毒的功效；艾叶可通经、活络、温阳，在灸法下释放药性与热性以达到治疗目的[4-5]。本研究着重探讨扶正解毒方联合艾灸对鼻咽癌患者放化疗后口腔黏膜损伤及炎性反应的影响。现将结果报道如下。