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Article(id=1322926495315931665, tenantId=1146029695717560320, journalId=1255847919539208197, issueId=1322926217711726961, articleNumber=null, orderNo=null, doi=10.13193/j.issn.1673-7717.2025.08.038, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=null, receivedDateStr=null, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1793339855269, onlineDateStr=2026-10-30, pubDate=1754755200000, pubDateStr=2025-08-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1793339855269, onlineIssueDateStr=2026-10-30, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1793339855269, creator=13701087609, updateTime=1793339855269, updator=13701087609, issue=Issue{id=1322926217711726961, tenantId=1146029695717560320, journalId=1255847919539208197, year='2025', volume='43', issue='8', pageStart='1', pageEnd='258', issueExtLink='null', onlineDate='null', pubDate='1754755200000', pubDateStr='2025-08-10', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=0, createTime=1793339789083, creator='13701087609', updateTime=1793340517761, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext={EN=IssueExt(id=1322929274071679978, tenantId=1146029695717560320, journalId=1255847919539208197, issueId=1322926217711726961, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1322929274071679979, tenantId=1146029695717560320, journalId=1255847919539208197, issueId=1322926217711726961, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null, downloadFileDto=null}, startPage=198, endPage=201, ext={EN=ArticleExt(id=1322926496758772242, articleId=1322926495315931665, tenantId=1146029695717560320, journalId=1255847919539208197, language=EN, title=Observation on the Effect of Jiawei Diyu Powder（加味地榆散）on Lung Cancer Targeted Therapy in Patients with Oral Mucositis of Yin Deficiency and Heat Toxin Syndrome, columnId=1256183365644968140, journalTitle=Chinese Archives of Traditional Chinese Medicine, columnName=Platform of Provincial Project, runingTitle=null, highlight=null, articleAbstract=
Objective

To study the therapeutic effect of Jiawei Diyu Powder（加味地榆散）on lung cancer targeted therapy in patients with oral mucositis of Yin deficiency and heat toxin syndrome.

Methods

86 patients with lung cancer targeted therapy for oral mucositis with Yin deficiency and heat toxin syndrome were randomly divided into two groups according to the order of treatment.There were 43 cases in each group.The patients in the control group were treated with Compound Chlorhexidine Gargle and oral administration of vitamin B2 and vitamin C，and those in the observation group were treated with Jiawei Diyu Powder on the basis of the control group.The oral mucositis grading，TCM symptom scores（dry mouth and throat，sore mouth and tongue，swollen gums and pain，hand-foot-heart heat），inflammatory factor levels［serum interleukin-6（IL-6），interleukin-8（IL-8）and tumor necrosis factor（TNF-α）］，Karnofsky performance score（KPS）and adverse reactions（abnormal taste，yellow tongue coating，nausea and vomiting，belching，etc.）were compared between the two groups.

Results

There was no significant difference in the classification of oral mucositis between the two groups before treatment（P>0.05）.After treatment，the observation group was significantly better than the control group（P<0.05）.After treatment，the above scores of the two groups were significantly decreased（P<0.05），and the scores of TCM symptoms in the observation group were significantly lower than those in the control group（P<0.05）.There was no significant difference in serum IL-6，IL-8 or TNF-αbetween the two groups before treatment（P>0.05）.After treatment，the levels of inflammatory factors in the two groups were significantly decreased（P<0.05），and the levels of the observation group were significantly lower than those of the control group（P<0.05）.After treatment，the KPS scores of the two groups were significantly increased，and the score of the observation group was significantly higher than that of the control group（P<0.05）.The incidence of adverse reactions in the observation group and the control group was 9.30%（4/43）and 6.98%（3/43），respectively，and the difference was not statistically significant（P>0.05）.

Conclusion

Jiawei Diyu Powder has a satisfactory therapeutic effect on patients with lung cancer targeted treatment of oral mucositis with Yin deficiency and heat toxin syndrome.It can significantly improve the classification of oral mucositis，eliminate the inflammation，relieve various discomfort symptoms，and improve the health level of the body.It is a safe and effective medication regimen.

, authors=Wei ZHAO, Cuiqiang GUAN, Hongbo GUO, authorsList=Wei ZHAO, Cuiqiang GUAN, Hongbo GUO, authorCompany=null, correspAuthors=Hongbo GUO, authorNote=null, correspAuthorsNote=null, copyrightStatement=null, copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1322926498662986267, articleId=1322926495315931665, tenantId=1146029695717560320, journalId=1255847919539208197, language=CN, title=加味地榆散方对肺癌靶向治疗引发口腔黏膜炎阴虚热毒证患者疗效观察, columnId=1256183369033965799, journalTitle=中华中医药学刊, columnName=省级项目平台, runingTitle=null, highlight=null, articleAbstract=
目的

研究加味地榆散对肺癌靶向治疗引发口腔黏膜炎阴虚热毒证患者的治疗效果。

方法

选取肺癌靶向治疗口腔黏膜炎阴虚热毒证患者86例，按照就诊顺序随机均分为两组，对照组和观察组各43例，对照组给予复方氯己定含漱液及口服维生素B2、维生素C治疗，观察组在对照组基础上给予加味地榆散治疗，比较两组患者的口腔黏膜炎分级、中医症状积分（口干咽燥、口舌生疮、牙龈肿痛、手足心热）、炎症因子水平［血清白细胞介素-6（Interleukin-6，IL-6）、白细胞介素-8（Interleukin-8，IL-8）及肿瘤坏死因子-α（Tumor necrosis factor-α，TNF-α）］、卡氏功能评分（Karnofsky performance status，KPS）及不良反应发生情况（味觉异常、舌苔发黄、恶心呕吐、嗳气等）。

结果

治疗前两组口腔黏膜炎分级情况差异无统计学意义（P>0.05），治疗后观察组显著优于对照组（P<0.05）。治疗前两组患者口干咽燥、口舌生疮、牙龈肿痛、手足心热积分差异无统计学意义（P>0.05），治疗后两组以上各项积分均显著下降（P<0.05），并且治疗后观察组各中医症状积分均显著低于对照组（P<0.05）。治疗前两组患者血清IL-6、IL-8和TNF-α水平差异均无统计学意义（P>0.05），治疗后两组以上各项炎症因子水平均显著降低（P<0.05），且观察组显著低于对照组（P<0.05）。治疗后两组KPS评分均显著升高，并且观察组显著高于对照组（P<0.05）。观察组、对照组不良反应发生率分别9.30%（4/43）、6.98%（3/43），差异无统计学意义（P>0.05）。

结论

加味地榆散对肺癌靶向治疗口腔黏膜炎阴虚热毒证患者的治疗效果满意，能够显著改善口腔黏膜炎分级状况，消除炎症、缓解各种不适症状，提高机体健康水平，是安全、有效的用药方案。

, authors=赵玮, 管翠强, 郭洪波, authorsList=赵玮, 管翠强, 郭洪波, authorCompany=null, correspAuthors=郭洪波, authorNote=

赵玮（1973-），女，山西长治人，副主任医师，学士，研究方向：口腔内科。

, correspAuthorsNote=
郭洪波（1969-），男，山西太原人，主任医师，硕士，研究方向：中医内科。E-mail：。
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赵玮（1973-），女，山西长治人，副主任医师，学士，研究方向：口腔内科。

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赵玮（1973-），女，山西长治人，副主任医师，学士，研究方向：口腔内科。

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组别例数治疗前治疗后
0级1级2级3级4级0级1级2级3级4级
对照组4306142036181360
观察组43071519213191010
Z值0.5152.339
P值0.6060.019
), ArticleFig(id=1322926503222194746, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322926495315931665, language=CN, label=表1, caption=

两组口腔黏膜炎阴虚热毒证患者口腔黏膜炎分级情况比较

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组别例数治疗前治疗后
0级1级2级3级4级0级1级2级3级4级
对照组4306142036181360
观察组43071519213191010
Z值0.5152.339
P值0.6060.019
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组别例数口干咽燥口舌生疮牙龈肿痛手足心热
治疗前治疗后治疗前治疗后治疗前治疗后治疗前治疗后
对照组434.91±0.732.16±0.59a3.28±0.621.97±0.44a4.03±0.822.05±0.60a3.67±0.642.51±0.50a
观察组434.85±0.892.57±0.51ab3.34±0.702.33±0.39ab4.11±0.782.73±0.55ab3.75±0.802.87±0.69ab
t值0.3423.4470.4214.0150.4645.4780.5122.770
P值0.7330.0010.675<0.0010.644<0.0010.6100.007
), ArticleFig(id=1322926503641625148, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322926495315931665, language=CN, label=表2, caption=

两组口腔黏膜炎阴虚热毒证患者中医症状积分比较（）

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组别例数口干咽燥口舌生疮牙龈肿痛手足心热
治疗前治疗后治疗前治疗后治疗前治疗后治疗前治疗后
对照组434.91±0.732.16±0.59a3.28±0.621.97±0.44a4.03±0.822.05±0.60a3.67±0.642.51±0.50a
观察组434.85±0.892.57±0.51ab3.34±0.702.33±0.39ab4.11±0.782.73±0.55ab3.75±0.802.87±0.69ab
t值0.3423.4470.4214.0150.4645.4780.5122.770
P值0.7330.0010.675<0.0010.644<0.0010.6100.007
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组别例数IL-6/（pg/mL）IL-8/（pg/mL）TNF-α/（ng/mL）
治疗前治疗后治疗前治疗后治疗前治疗后
对照组4321.51±2.6914.92±1.80a205.72±19.45186.20±21.33a141.35±13.4073.38±6.72a
观察组4320.92±2.4013.65±1.59ab207.11±18.37172.14±19.26ab140.27±15.0969.31±6.40ab
t值1.0733.4680.3413.2080.3512.876
P值0.2860.0010.7340.0020.7270.005
), ArticleFig(id=1322926505717805630, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322926495315931665, language=CN, label=表3, caption=

两组口腔黏膜炎阴虚热毒证患者炎症因子水平比较（）

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组别例数IL-6/（pg/mL）IL-8/（pg/mL）TNF-α/（ng/mL）
治疗前治疗后治疗前治疗后治疗前治疗后
对照组4321.51±2.6914.92±1.80a205.72±19.45186.20±21.33a141.35±13.4073.38±6.72a
观察组4320.92±2.4013.65±1.59ab207.11±18.37172.14±19.26ab140.27±15.0969.31±6.40ab
t值1.0733.4680.3413.2080.3512.876
P值0.2860.0010.7340.0020.7270.005
), ArticleFig(id=1322926505784914495, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322926495315931665, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数治疗前治疗后t值P值
对照组4366.72±5.4072.34±6.814.240<0.001
观察组4367.15±6.1376.82±7.166.727<0.001
t值0.3452.973--
P值0.7310.004--
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两组口腔黏膜炎阴虚热毒证患者治疗前后KPS评分比较（）

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组别例数治疗前治疗后t值P值
对照组4366.72±5.4072.34±6.814.240<0.001
观察组4367.15±6.1376.82±7.166.727<0.001
t值0.3452.973--
P值0.7310.004--
), ArticleFig(id=1322926506258870849, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322926495315931665, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数味觉异常舌苔发黄恶心呕吐嗳气合计
对照组432（4.65）1（2.33）1（2.33）0（0.00）4（9.30）
观察组430（0.00）1（2.33）1（2.33）1（2.33）3（6.98）
χ2值0.000
P值1.000
), ArticleFig(id=1322926506552472130, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322926495315931665, language=CN, label=表5, caption=

两组口腔黏膜炎阴虚热毒证患者不良反应情况比较

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组别例数味觉异常舌苔发黄恶心呕吐嗳气合计
对照组432（4.65）1（2.33）1（2.33）0（0.00）4（9.30）
观察组430（0.00）1（2.33）1（2.33）1（2.33）3（6.98）
χ2值0.000
P值1.000
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加味地榆散方对肺癌靶向治疗引发口腔黏膜炎阴虚热毒证患者疗效观察
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赵玮 , 管翠强 , 郭洪波
中华中医药学刊 | 省级项目平台 2025,43(8): 198-201
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中华中医药学刊 |省级项目平台 2025 , 43 (8) : 198 -201
加味地榆散方对肺癌靶向治疗引发口腔黏膜炎阴虚热毒证患者疗效观察
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赵玮, 管翠强, 郭洪波
作者信息
  • 山西医科大学第一医院，山西 太原 030001
通讯作者:
郭洪波（1969-），男，山西太原人，主任医师，硕士，研究方向：中医内科。E-mail：。
作者简介:

赵玮（1973-），女，山西长治人，副主任医师，学士，研究方向：口腔内科。

Observation on the Effect of Jiawei Diyu Powder（加味地榆散）on Lung Cancer Targeted Therapy in Patients with Oral Mucositis of Yin Deficiency and Heat Toxin Syndrome
Wei ZHAO, Cuiqiang GUAN, Hongbo GUO
Affiliations
  • First Hospital of Shanxi Medical University，Taiyuan 030001，Shanxi，China
出版时间: 2025-08-10 doi: 10.13193/j.issn.1673-7717.2025.08.038
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摘要
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目的

研究加味地榆散对肺癌靶向治疗引发口腔黏膜炎阴虚热毒证患者的治疗效果。

方法

选取肺癌靶向治疗口腔黏膜炎阴虚热毒证患者86例，按照就诊顺序随机均分为两组，对照组和观察组各43例，对照组给予复方氯己定含漱液及口服维生素B2、维生素C治疗，观察组在对照组基础上给予加味地榆散治疗，比较两组患者的口腔黏膜炎分级、中医症状积分（口干咽燥、口舌生疮、牙龈肿痛、手足心热）、炎症因子水平［血清白细胞介素-6（Interleukin-6，IL-6）、白细胞介素-8（Interleukin-8，IL-8）及肿瘤坏死因子-α（Tumor necrosis factor-α，TNF-α）］、卡氏功能评分（Karnofsky performance status，KPS）及不良反应发生情况（味觉异常、舌苔发黄、恶心呕吐、嗳气等）。

结果

治疗前两组口腔黏膜炎分级情况差异无统计学意义（P>0.05），治疗后观察组显著优于对照组（P<0.05）。治疗前两组患者口干咽燥、口舌生疮、牙龈肿痛、手足心热积分差异无统计学意义（P>0.05），治疗后两组以上各项积分均显著下降（P<0.05），并且治疗后观察组各中医症状积分均显著低于对照组（P<0.05）。治疗前两组患者血清IL-6、IL-8和TNF-α水平差异均无统计学意义（P>0.05），治疗后两组以上各项炎症因子水平均显著降低（P<0.05），且观察组显著低于对照组（P<0.05）。治疗后两组KPS评分均显著升高，并且观察组显著高于对照组（P<0.05）。观察组、对照组不良反应发生率分别9.30%（4/43）、6.98%（3/43），差异无统计学意义（P>0.05）。

结论

加味地榆散对肺癌靶向治疗口腔黏膜炎阴虚热毒证患者的治疗效果满意，能够显著改善口腔黏膜炎分级状况，消除炎症、缓解各种不适症状，提高机体健康水平，是安全、有效的用药方案。

肺癌  /  靶向治疗  /  口腔黏膜炎  /  阴虚热毒证  /  地榆散
Objective

To study the therapeutic effect of Jiawei Diyu Powder（加味地榆散）on lung cancer targeted therapy in patients with oral mucositis of Yin deficiency and heat toxin syndrome.

Methods

86 patients with lung cancer targeted therapy for oral mucositis with Yin deficiency and heat toxin syndrome were randomly divided into two groups according to the order of treatment.There were 43 cases in each group.The patients in the control group were treated with Compound Chlorhexidine Gargle and oral administration of vitamin B2 and vitamin C，and those in the observation group were treated with Jiawei Diyu Powder on the basis of the control group.The oral mucositis grading，TCM symptom scores（dry mouth and throat，sore mouth and tongue，swollen gums and pain，hand-foot-heart heat），inflammatory factor levels［serum interleukin-6（IL-6），interleukin-8（IL-8）and tumor necrosis factor（TNF-α）］，Karnofsky performance score（KPS）and adverse reactions（abnormal taste，yellow tongue coating，nausea and vomiting，belching，etc.）were compared between the two groups.

Results

There was no significant difference in the classification of oral mucositis between the two groups before treatment（P>0.05）.After treatment，the observation group was significantly better than the control group（P<0.05）.After treatment，the above scores of the two groups were significantly decreased（P<0.05），and the scores of TCM symptoms in the observation group were significantly lower than those in the control group（P<0.05）.There was no significant difference in serum IL-6，IL-8 or TNF-αbetween the two groups before treatment（P>0.05）.After treatment，the levels of inflammatory factors in the two groups were significantly decreased（P<0.05），and the levels of the observation group were significantly lower than those of the control group（P<0.05）.After treatment，the KPS scores of the two groups were significantly increased，and the score of the observation group was significantly higher than that of the control group（P<0.05）.The incidence of adverse reactions in the observation group and the control group was 9.30%（4/43）and 6.98%（3/43），respectively，and the difference was not statistically significant（P>0.05）.

Conclusion

Jiawei Diyu Powder has a satisfactory therapeutic effect on patients with lung cancer targeted treatment of oral mucositis with Yin deficiency and heat toxin syndrome.It can significantly improve the classification of oral mucositis，eliminate the inflammation，relieve various discomfort symptoms，and improve the health level of the body.It is a safe and effective medication regimen.

lung cancer  /  targeted therapy  /  oral mucositis  /  Yin deficiency and heat toxin syndrome  /  Diyu Powder（地榆散）
赵玮, 管翠强, 郭洪波. 加味地榆散方对肺癌靶向治疗引发口腔黏膜炎阴虚热毒证患者疗效观察. 中华中医药学刊, 2025 , 43 (8) : 198 -201 . DOI: 10.13193/j.issn.1673-7717.2025.08.038
Wei ZHAO, Cuiqiang GUAN, Hongbo GUO. Observation on the Effect of Jiawei Diyu Powder（加味地榆散）on Lung Cancer Targeted Therapy in Patients with Oral Mucositis of Yin Deficiency and Heat Toxin Syndrome[J]. Chinese Archives of Traditional Chinese Medicine, 2025 , 43 (8) : 198 -201 . DOI: 10.13193/j.issn.1673-7717.2025.08.038
正文
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肺癌是发病率、死亡率最高的恶性肿瘤，近年来随着分子生物学的深入研究和靶向药物的研发，精准靶向治疗应用于肺癌患者，使肺癌治疗有了长足的进展[1-2]。但是靶向治疗有可能对快速增长的黏膜上皮细胞造成损伤，从而引起口腔黏膜的炎症，致口腔疼痛难忍，不仅明显影响患者的进食、讲话及休息，还可能降低患者对于抗肿瘤治疗的耐受性和依从性，延迟甚或停止治疗，降低生活质量和抗肿瘤疗效[3-4]。靶向药物治疗后口腔黏膜炎属中医口疮、口糜等范畴，以脏腑功能失调、火热上挠口舌为主要病机，病位以心、脾、肾为主，阴虚热毒为常见证型[5]。据报道中医药已在肿瘤防治的临床实践中广泛应用，能起到增效减毒的作用[6]。本研究分析加味地榆散对肺癌靶向治疗口腔黏膜炎阴虚热毒证患者的治疗效果，现对相关病例资料进行总结并报道如下。
1　资料与方法
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1.1　一般资料
选取2021年10月—2022年12月医院诊治的肺癌靶向治疗口腔黏膜炎阴虚热毒证患者86例，纳入标准：均符合《原发性肺癌诊疗规范（2018年版）》[7]中肺癌诊断标准并进行靶向治疗者；依据《中国癌症症状管理实践指南——口腔黏膜炎》[8]中口腔黏膜炎诊断标准；符合《中药新药临床研究指导原则》[9]中阴虚热毒证标准；患者均知情同意并自愿参与研究项目。排除标准：精神/神经系统疾病或其他各种原因导致的交流障碍患者；严重心、肝、肾功能不全患者；未完成治疗的患者；研究中所用药物过敏史患者。将所有患者按照就诊顺序随机均分为两组，对照组和观察组各43例。对照组中，男25例，女18例；年龄39～76岁，平均（61.28±5.07）岁；肺癌病程5～12个月，平均（4.09±1.63）个月；靶向治疗药物奥西替尼13例，吉非替尼24例，厄洛替尼6例。观察组中，男27例，女16例；年龄40～77岁，平均（61.70±5.82）岁；肺癌病程4～13个月，平均（4.13±1.80）个月；靶向治疗药物奥西替尼14例，吉非替尼21例，厄洛替尼8例。两组患者一般资料差异无统计学意义（P>0.05），均衡可比。本研究内容经医院医学伦理委员会审核批准进行。
1.2　方法
对照组患者给予复方氯己定含漱液及口服维生素B2、维生素C治疗，复方氯己定含漱液（北京斯利安药业有限公司，国药准字H11020239）漱口，10～20 mL/次，早晚刷牙后含漱；维生素B2（广东恒健制药有限公司，国药准字H44020621）5 mg/次，3次/d；维生素C（浙江瑞新药业股份有限公司，国药准字H33021139）0.1 g/次，3次/d。观察组患者在对照组基础上给予加味地榆散治疗：地榆30 g，蒲公英30 g，马齿苋30 g，灵芝20 g，乌梅15 g，金银花15 g，连翘15 g，茜草根15 g，黄芩10 g，黄连5 g，甘草15 g，每方剂煎煮取汁150 mL，分早、晚2次服用，口腔含服5 min后咽下。两组患者治疗疗程均为2周。
1.3　观察项目
（1）口腔黏膜炎分级[10]：0口腔黏膜无异常；1级口腔黏膜有1～2个直径<1.0 cm的溃疡，口腔黏膜出现红斑伴有疼痛，但不影响进食；2级口腔黏膜有1个直径>1.0 cm的溃疡或（和）数个小溃疡，口腔黏膜出现红斑、溃疡，但能进食固体食物；3级口腔黏膜有2个直径>1.0 cm的溃疡，口腔黏膜出现严重的红斑和溃疡，不能进食固体食物；4级口腔黏膜有2个以上直径>1.0 cm的溃疡或（和）融合溃疡，溃疡融合成片，不能进食固体食物。（2）中医症状积分：将患者的主要症状口干咽燥、口舌生疮、牙龈肿痛、手足心热按照《中药新药临床研究指导原则》[9]进行积分，每个症状根据严重程度依次对应0、2、4、6分。（3）炎症因子水平：酶联免疫吸附法测定患者血清白细胞介素-6（Interleukin-6，IL-6）、白细胞介素-8（Interleukin-8，IL-8）及肿瘤坏死因子-α（Tumor necrosis factor-α，TNF-α）水平。（4）卡氏功能评分（Karnofsky Performance Status，KPS）：根据体力状况从死亡到正常依次分11个等级，分别对应0分到100分，得分越低则健康状况越差。（5）不良反应发生情况：观察有无味觉异常、舌苔发黄、恶心呕吐、嗳气等不良反应发生并如实记录。
1.4　统计学分析
数据分析工具采用统计软件包SPSS 23.0，计数资料用频数或比例表示，进行χ2检验，等级资料采用秩和检验，计量资料正态分布，用（）表示，进行t检验，P<0.05表示差异有统计学意义。
2　结果
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2.1　口腔黏膜炎分级情况比较
治疗前两组口腔黏膜炎分级情况差异无统计学意义（P>0.05），治疗后观察组显著优于对照组（P<0.05）。见表1。
2.2　中医症状积分比较
治疗前两组患者口干咽燥、口舌生疮、牙龈肿痛、手足心热积分差异无统计学意义（P>0.05），治疗后两组以上各项积分均显著下降（P<0.05），并且治疗后观察组各中医症状积分均显著低于对照组（P<0.05）。见表2。
2.3　炎症因子水平比较
治疗前两组患者血清IL-6、IL-8和TNF-α水平差异均无统计学意义（P>0.05），治疗后两组以上各项炎症因子水平均显著降低（P<0.05），且观察组显著低于对照组（P<0.05）。见表3。
2.4　KPS评分比较
治疗后两组KPS评分均显著升高，并且观察组显著高于对照组，差异有统计学意义（P<0.05）。见表4。
2.5　不良反应情况比较
观察组、对照组不良反应发生率分别9.30%、6.98%，差异无统计学意义（P>0.05）。见表5。
3　讨论
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中医学认为，肺癌靶向治疗所致的口腔黏膜炎虽病位在口，但与内脏有密切关系，脾开窍于口，心开窍于舌，肾脉连咽系舌本，两颊与齿龈属胃与大肠，任脉、督脉均上络口腔唇舌，表明其发生与五脏关系密切[11-13]。《素问·至真要大论篇》曰：“诸痛痒疮，皆属于心”。口疮之火，不独责之于心，机体虚弱，劳倦内伤，损伤脾胃，可致中焦枢纽失司，上下气机不通，上焦之阳不能下降，下焦之阴不能上行，心火独盛，循经上炎发病，此多为虚证[14-15]。
本研究结果提示常规西药治疗基础上给予加味地榆散效果更为显著。《太平圣惠方》地榆散方，由白蔹、地榆根、附子、白芷、当归、川芎、芍药构成，功能治伤止血；《仁斋直指方论》地榆散，由黄芪、地榆、枳壳、槟榔、黄芩、川芎、赤芍、槐花、白蔹、羌活、蜂房、炙甘草构成，功能清热理气、舒痔消肿；《卫生宝鉴》地榆散，由蒴藋、地榆、荆芥、苦参、蛇床子构成，功能清热化湿、消肿止痒；《外台秘要》地榆散，由白蔹、地榆根、附子、当归、白芷、川芎、芍药构成，功能治伤止血。可见，地榆散方剂在实际应用中根据需要可加减方药，在不同疾病的治疗中以求最佳效果。本研究中地榆凉血止血，解毒敛疮[16]；蒲公英清热解毒，消肿散结[17]；马齿苋清热解毒，凉血止血[18]；灵芝扶正固本，滋补强壮；乌梅敛肺，涩肠，生津[19]；金银花清热解毒，疏散风热；连翘具有清热解毒，消肿散结，疏散风热的功效[20]；生甘草有清热解毒，祛痰止咳，缓急止痛，调和诸药，痈肿疮毒等功效；茜草根能够行血止血，通经活络；黄芩具有清热燥湿，泻火解毒，止血的功能；黄连清热燥湿，泻火解毒[21]；以上诸药合用共同发挥清热解毒凉血、化阴生津敛疮的作用。有研究[22]初步揭示了山柰酚和槲皮素可能是地榆抗菌作用的物质基础之一，其作用机制可能与网络药理学预测的调节机体免疫和炎症反应等有关；连翘多种提取物以及多种活性成分如连翘酯苷A等均具有抗炎作用，通过影响炎症相关信号通路从而影响体内相关酶的活性、炎症介质的合成发挥抗炎作用，还能通过影响与能量代谢、脂质代谢和蛋白质代谢相关的代谢物发挥抗炎作用[23-25]。提示加味地榆散中多种药物组分具有抗炎作用，因此观察组血清IL-6、IL-8和TNF-α水平降低更显著。还有研究[26]提示地榆主要含有萜类及皂苷、鞣质及酚酸、黄酮类、木脂素类等化学成分，不仅具有抗炎、抗氧化、抗过敏等作用，还能够发挥抗菌抗病毒、抗肿瘤、抗溃疡、免疫调节等作用；蒲公英三萜类化合物抗菌消炎的同时具有抗肿瘤药学作用[27-28]；以上说明加味地榆散能够有效改善肺癌靶向治疗口腔黏膜炎阴虚热毒证患者的机体健康水平，促进康复。
由上可见，加味地榆散对肺癌靶向治疗口腔黏膜炎阴虚热毒证患者的治疗效果满意，能够显著改善口腔黏膜炎分级状况，消除炎症、缓解各种不适症状，提高机体健康水平，是安全、有效的用药方案。
基金
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  • 山西省中医药管理局科研项目(2023ZYYA023)
文献
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2025年第43卷第8期
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doi: 10.13193/j.issn.1673-7717.2025.08.038
  • 首发时间：2026-10-30
  • 出版时间：2025-08-10
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山西省中医药管理局科研项目(2023ZYYA023)
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    山西医科大学第一医院，山西 太原 030001

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郭洪波（1969-），男，山西太原人，主任医师，硕士，研究方向：中医内科。E-mail：。
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2种不同金属材料的力学参数
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Family		 属数
Number of
genus		 种数
Number of
species		 占总种数比例
Percentage of
total species (%)		 属
Genus		 种数
Number of
species		 占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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