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目的:探究中药雾化吸入及鼻腔中药灌洗法给药对鼻咽癌放疗后鼻腔、鼻咽组织的修复作用,为临床医生选择给药途径提供理论依据。方法:将80只豚鼠分为对照组、单纯照射组、鼻腔中药灌洗组、中药雾化吸入组,每组20只。除对照组外的豚鼠无麻醉下固定器固定,用Co-60治疗机产生的射线作鼻部照射,照射剂量30Gy,每次300c Gy,每周5次,共照射10次。照射开始当天即开始给药,鼻腔中药灌洗组用桂林医学院药学院提取的中药灌洗液对豚鼠鼻腔每天灌洗1次,共灌洗4周;中药雾化吸入组用桂林医学院药学院提取的中药雾化吸入液对豚鼠雾化吸入,每天1次,共雾化吸入4周;对照组及单纯照射组不用药。采集照射后第1天、2周、4周、8周、12周颈总动脉处血液行肝肾功能检测,同时取鼻咽部黏膜HE染色后行光学显微镜观察细胞形态,原位免疫组织化学法(TUNEL法)检测药物对黏膜组织内细胞凋亡的影响。结果:肝肾功能检测发现对照组、单纯照射组、鼻腔中药灌洗组及中药雾化吸入组ALT、AST、AST/ALT、BUN、Cr水平无统计学差异(P>0.05);HE染色发现除对照组外,其余3组均呈不同程度的炎症状态,单纯照射组HE染色显示炎症细胞数目最多,而鼻腔中药灌洗组最少;采用TUNEL法检测药物对黏膜组织内细胞凋亡的影响,发现除对照组外均出现TUNEL阳性细胞,其中鼻腔中药灌洗组TUNEL阳性细胞数最少,其次为中药雾化吸入组。结论:鼻腔灌洗法给药途径较中药雾化吸入法治疗对于鼻咽癌放疗后损伤的鼻黏膜修复作用更佳,能够促进炎症的消退,抑制细菌的生长。
OBJECTIVE: To investigate the effect of inhalation of Chinese herbs and nasal lavage on nasal and nasopharyngeal tissues after nasopharyngeal carcinoma radiotherapy, providing a theoretical basis for clinicians to choose the route of administration. Methods: Eighty guinea pigs were divided into control group, simple irradiation group, nasal cavity traditional Chinese medicine lavage group and traditional Chinese medicine inhalation group, with 20 rats in each group. Guinea pigs other than the control group were fixed without anesthesia, and irradiated with Co-60 treatment machine for nasal irradiation at a dose of 30 Gy, 300 c Gy each time for 5 times a week for a total of 10 shots. Irradiation began on the day of administration, nasal Chinese medicine lavage group Guilin Medical College School of Medicine extracts of lavage fluid on the guinea pig nasal lavage once a day for a total of four weeks lavage; Chinese medicine inhalation group Guilin Medical College medicine The College extracted aerosol inhalation solution of guinea pig inhalation, inhalation 1 times a day, a total of inhalation inhalation for 4 weeks; the control group and the irradiation group without medication. Blood samples were collected from the common carotid arteries at 1 day, 2 weeks, 4 weeks, 8 weeks and 12 weeks after irradiation. The liver and kidney were examined by HE staining. The morphological changes of the cells were observed by light microscopy. Immunohistochemistry TUNEL method was used to detect the effect of drugs on apoptosis in mucosal tissues. Results: There was no significant difference in the levels of ALT, AST, AST / ALT, BUN and Cr between the control group, the simple irradiation group, the nasal cavity traditional Chinese medicine lavage group and the Chinese medicine inhalation group (P> 0.05) In addition to the control group, the remaining three groups showed varying degrees of inflammatory state, the number of inflammatory cells in the group of irradiation alone was the highest, while that of the nasal cavity group was the least. The apoptosis of mucosal cells was detected by TUNEL method, TUNEL positive cells were found in the control group except for the TUNEL-positive cells in the nasal cavity lavage group, followed by the atomized inhalation group. CONCLUSION: Nasal lavage administration is more effective than traditional Chinese medicine nebulization in nasal mucosa repair for nasopharyngeal carcinoma after radiotherapy, which can promote the regression of inflammation and inhibit the growth of bacteria.