目的 探讨虎黄烧伤搽剂治疗鼻咽癌Ⅲ度放射性皮肤损伤的临床疗效。方法 选择2016年1月-2018年12月在重庆医科大学附属永川医院肿瘤科放射治疗过程中或结束后出现Ⅲ度放射性皮肤损伤的100例鼻咽癌患者为研究对象，将所有患者随机分为对照组和治疗组，每组各50例。对照组患者患处皮肤每日用0.9%氯化钠注射液清洗创面，创面清洗后用重组牛碱性成纤维细胞生长因子外用溶液喷涂3次；治疗组患者患处皮肤每日用0.9%氯化钠注射液清洗创面，创面清洗后用虎黄烧伤搽剂涂擦创面，3次/d。两组患者均到患处皮肤创面无湿性渗出愈合为止。观察两组的临床疗效，比较两组的临床症状改善时间、细菌感染情况、NRS评分、血清炎性因子水平。结果 治疗后，对照组和治疗组的总有效率分别为62.00%、96.00%，两组比较差异有统计学意义（P<0.05）。治疗后，治疗组湿性渗出停止时间、红肿消退时间、瘙痒疼痛消失时间均明显短于对照组，两组比较差异具有统计学意义（P<0.05）。治疗后，两组患者的细菌感染率均明显降低，两组差异有统计学意义（P<0.05）。并且治疗组患者细菌感染率明显低于对照组，两组差异有统计学意义（P<0.05）。治疗后，两组患者NRS评分轻度、中度和重度疼痛例数均显著降低，同组治疗前后比较差异有统计学意义（P<0.05）；且治疗后治疗组各疼痛例数明显低于对照组，两组差异有统计学意义（P<0.05）。治疗后，两组C反应蛋白（CRP）、降钙素原（PCT）、白细胞介素-6（IL-6）水平均显著降低，同组治疗前后比较差异有统计学意义（P<0.05）；并且治疗组CRP、PCT、IL-6水平均明显低于对照组，两组比较差异具有统计学意义（P<0.05）。结论 虎黄烧伤搽剂治疗鼻咽癌Ⅲ度放射性皮肤损伤具有良好的疗效，能缩短放射性Ⅲ度皮肤损伤的治疗时间，降低感染和炎性反应，具有一定的临床推广应用价值。

Objective To explore the clinical efficacy of Huhuang Shaoshang Liniment in treatment of Ⅲ degree radiation skin injury of nasopharyngeal carcinoma. Methods Patients (100 cases) with Ⅲ degree radiation skin injury of nasopharyngeal carcinoma in Department of Oncology of Yongchuan Hospital of Chongqing Medical University from January 2016 to December 2018 were randomly divided into control and treatment groups, and each group had 50 cases. Patients in the control group were sprayed three times with Recombinant Bovine Basic Fibroblast Growth Factor for external use, Liquid at the site of skin injury that it had been cleaned with normal saline, once daily. Patients in the treatment group were applied with Huhuang Shaoshang Liniment at the site of skin injury that it had been cleaned with normal saline, three times daily. Patients in two groups were healed until there was no wet exudation in the wound. After treatment, the clinical efficacies were evaluated, and clinical symptom improvement time, bacterial infection, NRS scores, and serum levels of inflammatory factors in two groups were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 62.00% and 96.00%, respectively, and there was difference between two groups (P<0.05). After treatment, wet exudation stop time, swelling subside time, and itching pain disappear time in the treatment group were significantly shorter than those in the control group, and there was difference between two groups (P<0.05). After treatment, the bacterial infection rates in two groups were significantly decreased, and the difference was statistically significant in the same group (P<0.05). And the bacterial infection rate in the treatment group was significantly lower than that in the control group, with significant difference between two groups (P<0.05). After treatment, mild cases, moderate cases and severe pain cases of NRS scores in two groups were significantly decreased, and the difference was statistically significant in the same group (P<0.05). And the observational indexes in the treatment group were significantly lower than those in the control group, with significant difference between two groups (P<0.05). After treatment, the levels of CRP, PCT, and IL-6 in two groups were significantly decreased, and the difference was statistically significant in the same group (P<0.05). And the observational indexes in the treatment group were significantly lower than those in the control group, with significant difference between two groups (P<0.05). Conclusion Huhuang Shaoshang Liniment has clinical curative effect in treatment of Ⅲ degree radiation skin injury of nasopharyngeal carcinoma, can shorten the treatment time of Ⅲ degree radiation skin injury, and reduce infection and inflammatory reaction, which has a certain clinical application value.

R976

重庆医科大学附属永川医院青年课题（YJQN2011032）