目的 观察加味四妙勇安汤治疗急性放射性食管炎的临床疗效。方法 将57例急性放射性食管炎热毒壅盛证患者随机分为观察组（29例）和对照组（28例），在氯化钠注射液100 mL联合维生素B12 0.25 mg 每日1次含漱常规治疗的基础上，观察组口服加味四妙勇安汤（配方颗粒），对照组口服康复新液，两组均治疗6周，比较两组患者治疗前后吞咽疼痛视觉模拟量表（visual analogue scale，VAS）评分、中医症状评分及Karnofsky功能状态（Karnofsky performance status，KPS）评分，并评估临床疗效。结果 治疗后两组患者VAS评分均较治疗前显著降低（P＜0.05），且观察组降低程度较对照组更为显著（P＜0.05）；对照组KPS评分较治疗前显著降低（P＜0.05），而观察组KPS评分较治疗前显著升高（P＜0.05），两组KPS评分差值比较，差异有统计学意义（P＜0.05）。治疗后对照组口干口苦评分较治疗前降低（P＜0.05），胸骨后灼热疼痛、便秘评分均较治疗前升高（P＜0.05）；观察组口干口苦、胸骨后灼热疼痛、便秘评分均较治疗前降低（P＜0.05）。两组治疗后口干口苦、胸骨后灼热疼痛、恶心呕吐、便秘评分差值比较，差异均有统计学意义（P＜0.05）。观察组疗效显著优于对照组（P＜0.05）。结论 加味四妙勇安汤治疗急性放射性食管炎有较好疗效，能显著改善临床症状。
Objective To investigate the clinical effect of Jiawei Simiao Yongan Decoction in the treatment of acute radiation esophagitis. Methods A total of 57 patients with acute radiation esophagitis with heat-toxin congestion and excessivenesswere randomly divided into observation group with 29 patients and control groupwith 28 patients. In addition to the conventional treatment of gargle with sodium chloride injection 100 mL+ vitamin B120.25 mg once a day, the patients in the observation group were given oral administration of Jiawei Simiao Yongan Decoction (formulated granules), and those in the control group were given oral administration of Kangfuxin Liquid; the course of treatment was 6 weeks for both groups. The two groups were compared in terms of Visual Analogue Scale(VAS) score, traditional Chinese medicine (TCM) symptom score, and Karnofsky Performance Scale (KPS) score of swallowing pain, and clinical outcome was evaluated for both groups. Results After treatment, both groups had a significant reduction in VAS score (P<0.05), and the observation group had a significantly greater reduction than the control group (P<0.05); the control group had a significant reduction in KPS score after treatment (P<0.05), while the observation group had a significant increase in KPS score after treatment (P<0.05), and there was a significant difference in the change in KPS score between the two groups (P<0.05). After treatment, the control group had significant reductions in the score of dry mouth/bitter taste (P<0.05) and significant increases in the scores of substernal burning pain and constipation (P<0.05), while the observation group had significant reductions in the scores of dry mouth/bitter taste, substernal burning pain, and constipation (P<0.05), and there were significant differences between the two groups in the changes in the scores of dry mouth/bitter taste, substernal burning pain, and constipation after treatment (P<0.05). The observation group had a significantly better treatment outcome than the control group (P<0.05). Conclusion Jiawei Simiao Yongan Decoction has a good clinical effect in the treatment of acute radiation esophagitis and can significantly improve clinical symptoms.
曲玉婷,康 宁,孙 颖,高 辰,宋凤丽,李 仝.加味四妙勇安汤治疗急性放射性食管炎热毒壅盛证临床研究[J].安徽中医药大学学报,2022,41(5):48-52复制