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目的探讨加减黄芪防己汤在喉癌术后局部放疗引起的迟发性淋巴水肿治疗中的效果。方法将60例喉癌手术后放疗患者分为中药治疗组和对照组,每组30例,每组包括20例部分喉切除及10例全喉切除病例,对照组中有13例行颈淋巴结清扫,术后仅予常规调强放疗。中药治疗组有16例行颈淋巴结清扫,术后行调强放疗同时给予黄芪防己汤加减,每日1剂,分2次口服,中药疗程为10周。放疗结束1个月后,利用改良Miller和LENT-SOMA评分系统分别对各组放疗引起的喉及颈部的迟发性淋巴水肿进行评估,采用视觉量表(VAS)对患者的生活质量进行评估。结果与对照组比较,中药治疗组喉及颈部迟发性淋巴水肿的反应分级明显降低(P<0.01,P<0.05),VAS分值亦降低(P<0.01)。结论加减黄芪防己汤能有效地预防和减轻放疗引起迟发性淋巴水肿反应。
Objective To investigate the effect of Huangqi Fangji Decoction on delayed lymphedema caused by local radiotherapy of laryngeal cancer. Methods Sixty patients with postoperative radiotherapy of laryngeal cancer were divided into two groups, 30 cases in each group, including 20 cases of partial laryngectomy and 10 cases of total laryngectomy, and 13 cases of cervical lymph node dissection in control group , After conventional IMRT. 16 cases of traditional Chinese medicine treatment of cervical lymphadenectomy after radiofrequency radiation therapy at the same time give astragalus antigonist plus or minus 1 day, 2 times orally, the Chinese medicine treatment for 10 weeks. One month after the end of radiotherapy, the modified Miller and LENT-SOMA scoring system were used to evaluate the delayed lymphedema of throat and neck caused by radiotherapy in each group, and the quality of life of patients was evaluated by visual scale (VAS) . Results Compared with the control group, the reaction grade of delayed laryngeal and neck delayed lymphedema significantly decreased (P <0.01, P <0.05) and the VAS score decreased (P <0.01). Conclusion Modified Astragalus and Antidote decoction can effectively prevent and relieve the delayed lymphedema reaction induced by radiotherapy.