Background:

Subjects with head and neck cancer (HNC) often experience post-treatment side effects, particularly radiation-induced oral mucositis (RIOM). This study aimed to explore the association of Chinese herbal medicine use with the sequent risk of RIOM among them.

Methods:

This cohort study used a nationwide health insurance database to identify subjects newly diagnosed with HNC, aged 20 to 60 years, who received treatment between 2000 and 2007. Among them, a total of 561 cases received CHM after HNC onset (CHM users); the remaining 2395 cases were non-CHM users. All patients were followed to the end of 2012 to identify any treatment for RIOM as the end point. Cox proportional hazards regression was used to compute the adjusted hazard ratio (aHR) of RIOM by CHM use.

Results:

During the follow-up period, 183 CHM users and 989 non-CHM users developed RIOM at incidence rates of 40.98 and 57.91 per 1000 person-years, respectively. CHM users had a lower RIOM risk than the non-CHM users (aHR: 0.68; 95% Confidence Interval: 0.58-0.80). The most potent effect was observed in those taking CHM for more than 1 year. Use of Baizhi, Danshen, Shao-Yao-Gan-Cao-Tang, Gan-Lu-Yin, Huangqin, Shu-Jing-Huo-Xue-Tang, and Xin-Yi-Qing-Fei-Tang, was significantly related to a lower risk of RIOM.

Conclusion:

Findings of this study indicated that adding CHM to conventional clinical care could be helpful in protecting those with HNC against the onset of RIOM. Further clinical and mechanistic studies are warranted.

中文翻译：

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中草药减少头颈癌患者放射性口腔黏膜炎：来自基于人群的健康声明的证据

背景：

患有头颈癌 (HNC) 的受试者经常会出现治疗后的副作用，尤其是辐射诱发的口腔粘膜炎 (RIOM)。本研究旨在探讨中草药使用与其中 RIOM 后续风险的关系。

方法：

本队列研究使用全国健康保险数据库，确定2000年至2007年间接受治疗的新诊断HNC受试者，年龄20-60岁。其中，HNC发病后接受CHM治疗的病例共561例（CHM使用者）；其余 2395 例为非 CHM 用户。对所有患者进行随访至 2012 年底，以确定任何 RIOM 治疗作为终点。Cox 比例风险回归用于计算通过 CHM 使用的 RIOM 的调整风险比 (aHR)。

结果：

在随访期间，183 名 CHM 用户和 989 名非 CHM 用户发展为 RIOM，发病率分别为每 1000 人年 40.98 和 57.91。CHM 用户的 RIOM 风险低于非 CHM 用户（aHR：0.68；95% 置信区间：0.58-0.80）。在服用 CHM 超过 1 年的人中观察到最有效的效果。白芷、丹参、芍药甘草汤、甘露银、黄芩、舒经活血汤、心宜清肺汤的使用与降低 RIOM 的风险。

结论：

这项研究的结果表明，将 CHM 添加到常规临床护理中可能有助于保护 HNC 患者免受 RIOM 的侵袭。需要进一步的临床和机制研究。