上海口腔医学

上海口腔医学 ›› 2025, Vol. 34 ›› Issue (5): 518-523.doi: 10.19439/j.sjos.2025.05.012

• 论著 • 上一篇    下一篇

CMC-Na口腔药膜联合rb-bFGF凝胶治疗头颈癌患者放射性口腔黏膜炎的效果评价

谢泽能1,2, 江银华2   

  1. 1.浙江中医药大学口腔医学院,浙江 杭州 310053;
    2.丽水口腔医院·丽水学院附属口腔医院,浙江 丽水 323000
  • 收稿日期:2025-03-21 修回日期:2025-08-01 出版日期:2025-10-25 发布日期:2025-10-31
  • 通讯作者: 江银华,E-mail: lsjyh1111@sina.com
  • 作者简介:谢泽能（1997-）,男,在读硕士研究生,E-mail: 820354103@qq.com

Efficacy of CMC-Na oral film combined with rb-bFGF gel in the treatment of radiation-induced oral mucositis in patients with head and neck cancer

Xie Zeneng1,2, Jiang Yinhua2   

  1. 1. School of Stomatology, Zhejiang Chinese Medical University. Hangzhou 310053;
    2. Stomatology Hospital of Lishui & The Affiliated Stomatology Hospital of Lishui University. Lishui 323000, Zhejiang Province, China
  • Received:2025-03-21 Revised:2025-08-01 Online:2025-10-25 Published:2025-10-31

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摘要： 目的:探讨羧甲基纤维素钠（sodium carboxymethyl cellulose,CMC-Na）口腔药膜联合重组牛碱性成纤维细胞生长因子（recombinant bovine basic fibroblast growth factor,rb-bFGF）凝胶对头颈癌（head and neck cancer,HNC）患者放射性口腔黏膜炎（radiation-induced oral mucositis,RIOM)的治疗效果。方法:选取 2022年6月—2024年1月于丽水市人民医院接受放射治疗后并发RIOM的31例HNC患者,随机分为A组（n=11）、B组（n=11）和C组（n=9）,分别采用CMC-Na口腔药膜+rb-bFGF凝胶治疗、rb-bFGF凝胶治疗、西吡氯铵含漱液治疗。在第0、5、10和15天,使用口腔黏膜炎（oral mucositis,OM）分级表和数字评分表（numeric rating scale,NRS）评价每例患者的OM等级和疼痛评分,并用口咽黏膜炎生活质量（Oropharyngeal Mucositis Quality of Life,OMQoL）量表评估治疗前后患者的生活质量情况。结果:A、B两组治疗后,疼痛评分和OM等级较治疗前显著降低（P<0.05）,而C组治疗前后无显著差异（P>0.05）。治疗后不同时间点对比显示,A组疼痛评分在第5天和第10天显著低于B组（P<0.05）,但第15天两组无显著差异（P>0.05）;OM等级仅在第10天时,A组显著低于B组（P<0.05）,第5天和第15天两组无显著差异（P>0.05）。A、B 两组患者生活质量较治疗前均有显著改善（P<0.05）,A组改善程度优于B组;相比之下,C组生活质量无显著提升（P>0.05）。结论:CMC-Na口腔药膜联合rb-bFGF凝胶治疗HNC患者RIOM效果良好,相比单独使用rb-bFGF凝胶效果更好,而西吡氯铵含漱液对RIOM治疗效果不明显。

关键词: 放射性口腔黏膜炎, 羧甲基纤维素钠, 重组牛碱性成纤维细胞生长因子, 药物输送系统

Abstract: PURPOSE: To investigate the therapeutic effect of sodium carboxymethyl cellulose (CMC-Na) oral film combined with recombinant bovine basic fibroblast growth factor (rb-bFGF) gel on radiation-induced oral mucositis (RIOM) in patients with head and neck cancer(HNC). METHODS: A total of 31 HNC patients with RIOM after radiotherapy in Lishui People's Hospital from June 2022 to January 2024 were randomly divided into three groups: group A (n=11), group B (n=11), and group C (n=9). Group A received CMC-Na oral film + rb-bFGF gel, group B received rb-bFGF gel alone, and group C received cetylpyridinium chloride mouthwash (control). On days 0, 5, 10 and 15, the OM grade and pain scores of each patient were evaluated using oral mucositis (OM) grading scale and numeric rating scale (NRS). The quality of life of patients before and after treatment was evaluated by using Oropharyngeal Mucositis Quality of Life (OMQoL) scale. RESULTS: After treatment in both group A and B, the pain scores and OM grades were significantly lower than those before treatment (P<0.05), while there was no significant difference in group C before and after treatment (P>0.05). Comparative analysis across time points revealed that pain scores in group A were significantly lower than those in group B on day 5 and 10 (P<0.05), with no significant difference on day 15(P>0.05). OM grades in group A were significantly lower than those in group B only on day 10 (P<0.05). Quality of life improved significantly in groups A and B(P<0.05), with greater improvement in group A, while no significant improvement was observed in group C(P>0.05). CONCLUSIONS: CMC-Na oral film combined with rb-bFGF gel demonstrates superior efficacy in treating RIOM in HNC patients compared to rb-bFGF gel alone, while cetylpyridinium chloride mouthwash shows no significant therapeutic effect.

Key words: Radiation-induced oral mucositis, Sodium carboxymethyl cellulose, Recombinant bovine basic fibroblast growth factor, Drug delivery systems

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