放射線治療に伴う急性口腔粘膜炎に対するアクトベギンの治療効果について

[Therapeutic effect of Actovegin on acute oral mucositis caused by radiotherapy].

抄録

目的：放射線治療による急性口腔粘膜炎に対するActoveginの臨床効果を検討する。方法： 2015年7月から2017年9月までに青海省第五人民病院腫瘍科に入院した上咽頭がんの放射線治療により急性口腔粘膜炎を発症した患者113名を、実験群（57例）と対照群（56例）に無作為に分けた。実験群の患者にはAiweizhiを投与し、対照群の患者には新しいリハビリテーションを投与した。VASスコア、口腔粘膜炎のグレード、血清CRP、IL-6、TGF-β1、TNF-αの変化を2群間で比較した。データはSPSS16.0ソフトウェアパッケージで解析した。結果：治療前、2群間でVASスコアに有意な差はなかった（P>0.05）。治療開始1週間後と2週間後には、2群のVASスコアは治療前に比べて有意に低下した（P<0.05）。実験群のVASスコアは対照群よりも有意に低かった(P<0.05)。投与2週間後、実験群の口腔粘膜炎のグレードは対照群のそれよりも有意に低かった（P<0.05）。投与前の血清CRP、IL-6、TGF-β1、TNF-αレベルには2群間で有意な差はなかった（P>0.05）。2週間の治療後、両群の血清CRP、IL-6、TGF-β1、TNF-αのレベルは、治療前に比べて有意に低下した（P<0.05）。実験群のCRP、IL-6、TGF-β1、TNF-αの血清レベルは、対照群のそれよりも有意に低かった（P<0.05）。結論。アクトベギンは、放射線治療を受けた患者の急性口腔粘膜炎に明確な臨床効果を示し、患者の痛みを大幅に軽減し、血清炎症因子のレベルを低下させることができる。

PURPOSE： To explore the clinical effect of Actovegin in the treatment of acute oral mucositis in patients with radiotherapy. METHODS： One hundred and thirteen patients with acute oral mucositis caused by radiotherapy for nasopharyngeal carcinoma admitted to the Department of Oncology, the Fifth People's Hospital of Qinghai Province from July 2015 to September 2017 were randomly divided into the experimental group (57 cases) and control group (56 cases). Patients in the experimental group were treated with Aiweizhi, while patients in the control group were treated with new rehabilitation. The changes of VAS score, oral mucositis grade, serum CRP, IL-6, TGF-β1 and TNF-α were compared between the 2 groups. The data were analyzed with SPSS 16.0 software package. RESULTS: Before treatment, there was no significant difference in VAS score between the 2 groups (P>0.05). After 1 week and 2 weeks of treatment, the VAS scores of the two groups were significantly lower than those before treatment (P<0.05). The VAS score of the experimental group was significantly lower than that of the control group (P<0.05). After 2 weeks of treatment, oral mucositis grade of the experimental group was significantly lower than that of the control group (P<0.05). There was no significant difference in serum CRP, IL-6, TGF-β1, and TNF-α level between the 2 groups before treatment (P>0.05). After 2 weeks of treatment, the level of serum CRP, IL-6, TGF-β1, and TNF-α in both groups was significantly lower than that before treatment (P<0.05). The serum level of CRP, IL-6, TGF-β1 and TNF-α in the experimental group was significantly lower than that in the control group (P<0.05). CONCLUSIONS: Actovegin has a clear clinical effect on acute oral mucositis in patients with radiotherapy, which can significantly alleviate the pain of patients and reduce the level of serum inflammatory factors.