Nasopharyngeal carcinoma is one of the common cancers in otolaryngology, and the current treatment is mainly radiotherapy. If detected early and treated timely, the prognosis is generally good. However, the side effects after radiotherapy should be paid attention to, to reduce patients’ pain as much as possible, to improve the quality of life and to prevent recurrence, etc. We can adopt different treatment methods to cope with it in different stages.
Internal treatment: The following stages are mainly common and are divided and treated as follows.
I. Thermal toxicity burn stage.
This stage can generally be born in the course of radiotherapy, and most patients come to the clinic immediately after the end of radiotherapy. Patients have severe sore throat, painful swallowing, even difficult swallowing, dry mouth, hands do not leave the cup, or accompanied by dental allergy, chewing weakness, etc. Local examination: congestion in the pharynx, oral ulcers, blood oozing from the gums, skin burns on the neck, dry nasopharynx, fine pulse, red tongue with dry coating, etc.
Identification: heat and toxin burning, deficiency of both qi and yin. Treatment: Clearing heat and detoxifying toxins, benefiting Qi and nourishing Yin
Bamboo leaf, raw gypsum, raw earth, northern ginseng, basil ginseng, prunus ginseng, maidenhair, white foxglove, fried hawthorn, orris, licorice.
Ionizing radiation is a kind of heat substance, which kills cancerous toxins and at the same time retains heat in the body, causing heat and toxins to be hot and injuring both qi and yin, so treatment should be balanced.
II. Qi and Yin deficiency stage.
At this stage, the main signs and symptoms are Qi-Yin deficiency, with dryness as the main symptom. Patients mainly show dry mouth and throat, thirsty for drinks, rough and non-moist skin, dry stools, red tongue with little coating and fine pulse. On examination, the mucous membrane of the nose, nasopharynx and oropharynx is congested and dry, or there are crusts.
In the specific identification, attention should be paid to the deficiency of lung, spleen, stomach and kidney yin.
If there is dryness of the mouth, dryness of the throat, dry cough, little sputum, dryness of the throat, heat in the heart of the hands and feet, night sweating, constipation, little redness of the mantle and little fluid, thin and counted pulse and other symptoms of lung yin deficiency, the treatment should be to nourish yin and clear the lung, generate fluid and moisten dryness. Use nourishing Yin and clearing the lung soup or Baihegujin Tang plus or minus. Commonly used drugs: Mulberry white peel, ground bark, lily, maitong, asparagus, licorice, raw earth yellow, etc.
If there is dry vomiting, erratic vomiting, nausea and fever, the treatment is to strengthen the spleen and nourish the stomach, to produce fluid and moisten dryness. The formula uses Sha Shen Mai Dong Tang with addition and subtraction, commonly used drugs: Sha Shen, Mai Dong, Dendrobium, licorice, jujube, prunus ginseng, kudzu root, grain bud, malt, bamboo rhizome, hawthorn, etc.
For those who have symptoms of kidney essence deficiency, the treatment is to tonify the kidney and consolidate the essence, nourish Yin and lower fire. The formula uses Liu Wei Di Huang Wan plus or minus, commonly used drugs: Sheng Di Huang, Mudan Pi, Ze Di, Cornus, Yam, Fu Ling, Zhen Zhen Zi, Cuscuta, etc.
After a period of recuperation after radiotherapy, the heat toxin in the patient’s body has been discharged, but the essence and liquid depletion caused by the heat toxin of radiotherapy is far from being recovered.
Third, the stage of spleen and stomach disorders.
The main manifestations are white face, puffy head and face, poor appetite, nausea and anorexia, erratic vomiting, abdominal distension and pain, chest and epigastric fullness, loose and weak stool, pale tongue and thick white fur. The mucous membrane of the nasopharynx is light red, or pus and snot crusts are seen. The treatment is to strengthen the spleen, benefit the qi, harmonize the stomach and stop vomiting. The formula is Ginseng and Atractylodes macrocephala with addition and subtraction. Commonly used drugs: Radix et Rhizoma Ginseng, Poria, Atractylodes Macrocephalae, Coix Coix seeds, fried lentils, wheat sprouts, grain buds, sand, bamboo rhizome, Chen Pi, Phalaris, cat’s claw.
At this stage, because the spleen and stomach are damaged after radiotherapy, they are unable to transport water and grain, and water-dampness is blocked from transporting. When the spleen and stomach are healthy, nutrients can be digested and absorbed, and water and grain essence can be distributed throughout the body, which is beneficial for patients to expel evil toxins from the body, restore physical strength and recover early.
Fourth, the stage of Qi and Blood deficiency and internal trapping of evil toxins.
Patients have pale complexion, fatigue, little breath and lazy speech, bad odor or bad smell in the mouth and nose, headache, light tongue with thin coating or little fluid and dryness, and weak pulse. The nasopharynx has yellow-green crust, bad odor, blood oozing, cerebral edema and tumor recurrence. The general condition of patients with this type of disease is poor and the prognosis is also poor.
All of the above types can be added as appropriate to clear heat and detoxify, anti-cancer products, such as three leaf green, hairy mushroom, catkin, heavy floor, white flowered snake tongue grass, half branch lotus, half side lotus, cat ginseng, vine pear root, Wei Ling Xian, etc.
External treatment: External treatment is an important treatment after radiotherapy for nasopharyngeal cancer, mainly including cleaning and functional exercise, which is applicable to all stages after radiotherapy.
1.Cleaning.
You can rinse the nasopharyngeal cavity by yourself with saline or water every day. The patient should sit in a seated position with the head to one side and the head slightly downward. Place the disposable infuser with the needle removed in the anterior nostril and the saline bottle at the other end above the patient, the height of which should not be too high and the speed should not be too fast when rinsing. Rinse 1~2 times a day. If possible, it is best to use a nasal washer, which can be heated and pressurized to rinse the nasal cavity and nasopharynx, so that the mucus and scabs attached to the nasal cavity and nasopharynx can be rinsed thoroughly and the odor can be removed, so that the nasopharynx can be kept moist and the mucosa can be repaired.
2, functional exercise.
(1) wipe teeth and knock about 100 times a day to promote blood circulation of periodontal tissues, enhance the resistance of periodontal tissues, prevent teeth from loosening and premature loss.
(2) Open mouth exercise: do open mouth action every day, try to open the mouth as wide as possible, while doing open and close action, or do bite hot water bottle cork action for a few minutes, ten minutes, exercise the temporomandibular joint, can prevent the joint stiffness, resulting in mouth opening difficulties, unable to eat. This situation is not uncommon in clinical practice, so it is very important to insist on mouth opening exercise.
In Chinese medicine treatment after radiotherapy for nasopharyngeal carcinoma, identification is still the key, and I believe that the treatment is always about replenishing the deficiency and fixing the root. After radiation therapy, the patient has suffered unprecedented damage to the body’s qi, blood and fluids, and all the veins have been lost, and both yin and yang have been damaged.