目的 分析维生素 B2 联合康复新液对头颈部肿瘤放疗患者的口腔黏膜炎和营养状况的影响。 方法 前瞻性选择 2020 年 1 月至 2022 年 1 月入南京医科大学第一附属医院确诊头颈部肿瘤患者共 108 例,均采用强调适形放疗技术,总治疗剂 量为 60~ 74 Gy,每天 1 次,每周 5 次,持续 6~ 7 周;可同时联合化疗。 所有患者均出现口腔黏膜炎,然后将其随机分为对照组 和试验组各 54 例,对照组仅采用维生素 B2 口服,试验组联合维生素 B2 和康复新液。 根据放射治疗肿瘤组(RTOG)标准评估 口腔黏膜炎的严重程度(Ⅲ/ Ⅳ级),采用视觉模拟评分法(VAS) 评分评估疼痛程度,营养指标包括体重丢失量、体质指数 (BMI)丢失量、白蛋白丢失量、前白蛋白丢失量、血红蛋白丢失量和总淋巴细胞计数丢失量,以及患者主观整体评估(PGSGA)评分,不良反应包括口干、恶心呕吐、血小板减少、中性粒细胞减少、神经毒性和肾毒性。 结果 试验组Ⅲ/ Ⅳ级口腔黏膜 炎的发生率比对照组明显下降,口腔黏膜炎的消失时间比对照组缩短,差异有统计学意义(P<0. 05)。 两组治疗后 2 h、4 h 和 6 h 疼痛 VAS 评分均比治疗前明显下降,但试验组比对照组进一步降低,差异有统计学意义(P<0. 05)。 试验组治疗后 4 周和 7 周的体重丢失量、BMI 丢失量以及治疗 7 周的白蛋白丢失量均比对照组显著下降,差异有统计学意义(P<0. 05)。 试验组治 疗后 7 周的 PG-SGA 评分显示,营养状况明显优于对照组(P<0. 05)。 两组不良反应发生率比较,差异无统计学意义(P> 0. 05)。 结论 维生素 B2 联合康复新液能够显著改善头颈部肿瘤放疗患者的口腔黏膜炎和营养状况,减轻疼痛。

Objective To analyze the effects of vitamin B2 combined with Kangfuxin Solution on oral mucositis and nutritional status of patients with head and neck cancer after radiotherapy. Method A total of 108 patients with head and neck cancer diagnosis into our hospital from January 2020 to January 2022 were prospectively enrolled. They were all treated with intensity-modulated radiotherapy the total treatment dose was 60 ~ 74 Gy once a day five times a week for 6 ~ 7 weeks It can be combined with chemotherapy at the same time. All patients had oral mucositis then they were randomly divided into control group and observation group with 54 cases in each group. The control group only took vitamin B2 orally and the observation group combined with vitamin B2 and Kangfuxin solution. The severity of oral mucositis grade Ⅲ/ Ⅳ was assessed according to the Radiation Therapy Oncology Group RTOG standard the degree of pain was assessed by visual analogue scale VAS . Nutritional indicators included weight loss body mass index BMI loss albumin loss prealbumin loss hemoglobin loss and total lymphocyte count loss as well as Patient Generated – Subjective Global Assessment PG-SGA score adverse reactions included dry mouth nausea and vomiting thrombocytopenia neutropenia neurotoxicity and nephrotoxicity. Result The incidence of grade Ⅲ/ Ⅳ oral mucositis in the observation group was significantly lower than that in control group the disappearance time of oral mucositis was shorter than control group too P < 0. 05 . The pain VAS scores of the two groups at 2h 4hand 6h after treatment were lower than before treatment and they in the observation group was furtherly less than control group P < 0. 05 . The weight loss and BMI loss at 4 and 7 weeks after treatment albumin loss at 7 weeks after treatment in the observation group were significantly lower than those in control group P < 0. 05 . The PG-SGA score of the observation group 7 weeks after treatment showed that the nutritional status was better than control group P < 0. 05 . There was no difference of the incidence of adverse reactions between the two groups P > 0. 05 . Conclusion Vitamin B2 combined with Kangfuxin Solution can greatly improve the oral mucositis and nutritional status of patients with head and neck cancer after radiotherapy reduce pain which has a good clinical value.