Nghien cifu YDHCT Viet Nam
y iTNG D U N G Y H O C LU'ONG TU* T R O N G U>JG THU^ NHI K H O A The application of quantum medicine in children's oncology
*Tran Quoc Binh \ ** Le Thi Thuy Dung ^ Prityko D.A ^ Gusev L.I "
' Benh vien Y hpc co truyen TW, ^ Trucmg DH Y Hd Npi, Trung tdm thuc hdnh khoa hpc tre em Matxcova, ' To chirc y hpc luang tit Matxcova
Tdm tat
Trong bdi long quan ndy de cap den vdn de ung dung lieu phdp dieu tri bdng laze trong ung thu nhi. Cdc trudng hpp benh ly trong ung thu nhi dupe dp dung rpng rdi lieu phdp laze do la:
nhirng benh ly do cdc tdc dung phu cua dieu trf hod chdt va xg trj, cdc bien chimg sau phau thudt.
Trong bdi ndy cung dua ra cdc bdng chung nghien cuu ciia cdc tdc gid nudc ngodi, cdc nhd ung thu nhi khdc ve viec su dung laze. Tir ket qud do cho thdy bdng chimg de ung dung rang rdi dieu trj laze trong ung thu nhi.
Tir khoa: y hpc lirffng tfr; ung thir tre em.
Summiiry
T H E APPLICATION OF Q U A N T U M MEDICINE IN CHILDREN'S O N C O L O G Y
This review refers to the application of laser therapy in children's oncology The pathological cases of pediatric cancstrs which are widely applied with laser therapy are: the diseases caused by the side effects of chemotherapy and radiation therapy, post-operative complications. This article also provides evidences of other pediatric oncologists about laser application. The research results show us the evidences of widespread laser application in the treatment of children's oncology.
Key words: quantum medicine; children's oncology.
Dja chi lien hj; Tran Quoc Binh-Benh vien Y hpc co truyen TW Ngay nhan bai: 06/10/2014 Dja chi email: [email protected] Ngay phan bifn: 18/10/2014 Phan bi|n khoa h^c: PGS.TS. Nguyen Nhugc Kim Ngay dSng bio: 19/12/2014
• PGS.TS; •*TS.BS
Journal of research in viet nam traditional medicine and pharmacy
Trong Nhi khoa, y hoc lugng tii da chimg minh duac vai tro lam sang va tinh an toan khong chi doi vai nhom tre ion, ma ca trong viec dieu tri tre sa sinh dii thang va thieu thang co nhung bien chung som sau de vai muc dich dieu hoa he thong than kinh - phan xa, he than kinh trung uong, va cac roi loan ho hap. Biic xa laze tang cuong hieu qua cua cac loai thuoc nhu thuoc khang sinh, thuoc giam dau, thuoc an than va gay ngii. Tir nhung kinh nghiem diic ket tir viec sir dung biic xa laze trong thuc hanh nhi khoa va ung thu a nguai Ion cho phep ap dung trong ung thu nhi.
O truong dai hpc khoa hoc nghien ciju ung thu va cac benh mau a tre em thupc trung tam ung thu Nga (true thupc vien han lam y hpc Nga) tir giiia nhirng nam 80 cac nha khoa hpc Lobanov va Poliakovum la nhirng nguai dau tien ap dung biic xa laze trong dieu tri cac bien chiing do xa tri.
Ket qua la tat ca cac truong hop dieu tri deu cho ket qua tot. So sanh thai gian cac ton thuang bien mat hoan toan 6 tre em duac tri lieu bang biic xa laze vai nhom chiing truac do da cho
thSy, neu duac tri lieu bang laze thai gian se giam dugc 28% [1,3,4,5].
Dieu tri bing laze con dupe su dung nhieu ban trong ung thu nhi doi vai cac benh ly viem loet niem mac.
Viem loet niSm mac la nhiing ton thuang niem mac d ^ g xung huyet hoac xung huyet - loet ciia nhiem mang mieng, hau hong, thuc quan, rat thuong gap, va la mpt trong so nhimg bien chung nguy hiem ciia qua trinh dieu tri benh ung thu. Neu nguai Ion khi dugc hoa tri lieu thong thuang, tan so gap bien chiing viem loet la tu 1 0 - 50%, thi a tre em con so nay la tir 50 - 80% [10].
Tai Truong dai hpc khoa hpc nghien ciiu ung thu va cac benh mau 6 tre em thupc trung tam ung thu Nga true thupc vien y hpc Nga mang ten Blokhina tinh cho dSn nam 2005 co hon 1000 benh nhan. Nhiing t6n thuong niem mac mieng va he tieu hoa la mpt van de nghiem trpng d6i voi tre dang dugc di^u tri hoa ch4t. Khi do, niem mac mieng ton thuang, c6 nhiing vet loet co kich thuoc va dp sau khac nhau, tre dau va gan nhu khong the an uong dugc. Nhirng tnrong hgp nang co the din d8n viec hoan diSu tri keo dai.
Trong dieu tri benh viem loet niem
Nghien cuu YDHCT Viet Nam Sd43 - 2014 m^c CO the sii dung cac loai thudc x4c
tir cac loai la cay de xuc mieng, hoac su dung cac dich pha ciia mot s6 loai thuoc, nhung phuang phap dieu tri nay can nhieu thai gian, va thuang la mat tir 7 - 10 ngay de niem mac h6i phuc.
Chung toi sir dung biic xa laze cuong dp thap cho nhom benh nhan nay va nhan thay hieu qua ngay 6 nhung ngay diu tien khi bat dau tri lieu. Hieu qua dat dugc hoan toan a ngay thii 3 d^n thii 5. Hieu qua nhanh nhat dat dugc 6 nhom tre bu me: giam ngay phii nS tai cho, mat cac trieu chiing nhiem tning va tre tra nen khoe ngay [3],
O nhirng benh nhan dugc dieu trj y hpc lupng tur tir truac voi muc dich phong benh viem loet niem mac (a hon 500 benh nhan), niem mac mieng gan nhu khong b; ton thuong hoac ton thuang rat it va khong gay bat cii kho chju nao a tre.
Ciing lien quan den kha nang chong chpi ciia co the doi vai benh ly nhiem triing giam rat manh tren nen ung thu, a tre em nhat la cac benh ly viem duong ho hap tren va viing hau hgng. Khi do iing dung buc xa laze co the cho phep giam lam giam viem niem mac va giam xuat tiet trong cac benh viem mui, cung nhu lam giam ti^t dam a benh viem phe quan.
Hieu qua cua dieu tri bang laze a ca nhiing truong hgp viem tinh mach, cac vet thuang sau phau thuat lau lien va cac vet loet do nam lau. Ciing nhu trong dieu tri viem loet niem mac, cac benh ly nay neu dugc dieu tri bang laze ciing ghi nhan dugc nhiing cai thien rat nhanh, vi du benh viem tinh mach sau hoa chat, nhanh chong cho thay giam phii ne, giam hoai tii te bao do thuoc tren da. Neu dugc dieu tri ngay, chi sau 2 - 3 lan da thay het dau hoan toan, bet phii va nong tai cho.
Nhimg truong hgp vet thuang sau phau thuat dugc dieu trj bang birc xa laze cung cho thay hieu qua dang ke.
Thai gian lanh vet thuong thuang giam xuong 1 , 5 - 2 lan. Viec dieu tri cac bien chiing bang birc xa laze co the cho phep thirc hien diing cac phac do hoa chat va phau thuat, tranh dugc viec dieu tri trieu chiing bang cac thuoc chong viem va giam dau, lam tang siic khoe cho benh nhi trong qua trinh tri lieu [2].
O truong dai hpc khoa hpc nghien ciiru ung thu va cac benh mau a tre em thugc trung tam ung thu Nga true thugc vien y hpc Nga da thuc hien nghien ciru hieu qua ciia biic xa laze trong hoat dpng mien dich te bao o tre em. Phuong phap thuc hien la chieu
Journal of research in viet nam traditional medicine and pharmacy No 43 - 2014
biic xa laze vao nhirng mach mau Ion nhu mach canh, mach canh tay, mach duoi don va vung mach khoeo. Tan so biic xa la 50 Hz, thai glan chieu doi voi tre Ion la 5 - 10 phiit (birc xa doi vai dong mau ca hai nguon dong thai).
Moi khoa khoang tir 2 - 3 lan chieu.
Doi vai benh nhan dugc thuc hien nhieu hon 2 !an chieu, cho thay tang so luang te bao lympho T trucmg thanh, te bao lympho T lie che. Hieu qua cho thay ro ret, khong ghi nhan dugc truong hgp tac dung phu va bien chung nao[2, 3].
Nhirng nghien ciiu y van truoe day cho thay, a Chau Au da iing dung y hpc lugng tu vao ung thu nhi tir 10 nam tra lai day va chi ap dung doi voi nhirng truong hgp viem loet niem mac [4,8,9].
O khoa ung thu nhi thupc Benh vien Lien ban Gran du Sil (Brazil), trong khoang thoi gian tir thang 10 nam 2005 dSn thang 5 nam 2006 thuc hien thir nghiem lam sang ngau nhien CO doi chung ve hieu qua cua biic xa laze trong dieu tri benh viem niem mac. 21 benh nhan, dp tuoi trung binh la 8,2 (±3,1) tuoi, dang dieu tri hoa ch4t. 3 tre (18%) do benh u dac 18 (86%) do benh bach cau cap va i*
lympho. Tat ca tre nay deu dugc dieu
tri hoa chat va co xuat hien viem niem mac. 9 tre dugc sii dung dieu tri laze ban din hong ngoai, 12 tre thupc nhom chiing. Thai gian khoi viem niem mac hoan toan a nhom chi'nh la 5,8±2 ngay, va nhom chiing la 8,9±2,4 ngay (P = 0,004). Nhimg nha nghien curu di d^n ket luan can phai su dung dieu tri laze la bien phap lira chpn hang dau cho nhimg tre bi viem niem mac do hau qua ciia hoa chat.
6 khoa Than kinh, truong dai hpc Milwaukee (thupc bang Wisconsin, My), thuc hien nghien ciiu ve hieu qud ciia diot phat sang trong di6u tri viem niem mac. Nghien ciru bao gom 32 tre em dugc diet tuy de chuan bi cho viec cay ghep hiy xuong. Tir sau ghep tiiy, tat ca tre em trai qua chieu biic xa anh sang len niem mac ma trai va phia ben trai ciia luoi, va chieuben phai tia gia (nhom chiing). KSt qua la, tan suit viem loet mieng la 53%, so vai tan suit du kien 70-90% (s6 lieu dich tl hpc truac do). Khong phat hien dugc su khac biet dang ke giira hai ben trai va phai cua mieng. Tnrac do, tai benh vien nay dugc khao sat hieu qua cua cac tia laze hong ngoai trong benh ly nay, cung cho thay vai tro quan trpng ciia didu tri laser. Tuy nhien, cac nha nghien curu tin ring cac lieu phap LED
Nghien cim YDHCT Viet Nam Sd 43-2014
la mpt phucmg phap hiiu ich dk phong chdng viem niem mac [10].
Cac nha nghien ciiu Han Qu6c da so sanh hieu qua didu tri viem niem mac trong 9 tre em (3 tre em bi » xuong ac tinh va 6 tre em bi benh bach ciu) bang tia laze He-Ne va Ga-Al. 6 tit ca cac benh nhan deu cho thay hieu qua tdt. Khong phat hien dugc su khac biet dang ke trong hieu qua ciia viec su dung laze He-Ne va Ga-Al [8].
Tir thing mpt den thang tam nam 2010, tai Benh vien Dai hgc Ghent (Bi), Khoa Ung thu va Huyet hpc Nhi,cung voi khoa huyet hpc va nhom ghep te bao goc da thuc hien nghien ciiu danh gia hieu quacua laze cuong dp thap trong dieu tri cac viem loet niem mac do tac dung phu ciia hoa chit giy ra doi voi huyet hpc olon va tre em bi benh ung thu - mau. Nghien ciiu bao gom 71 benh nhan (41 tre em va 30 nguoi Ion) mac benh ic tinh:
bach cau cip (n = 28), u lympho (n = 20), u xuong ac tinh (n = 8), u nguyen bao thin kinh (n = 3), da u tuy (n = 4 ) va khac (n = 8) bi viem niem mac gay
ra bai hoa tri. Dp tuoi ciia benh nhan dao dpng tir 1 nam den 75 tuoi.
Ket qua nghien ciiu cho thiy bieu hien dau nhanh chong mit di a hau het cac benh nhan. Hieu qua ciia dieu tri bang laze thay ngay chi sau sau 2-3 lan chieu o ca tre em va nguoi Ion [9].
Ciing tai benh vien Ung thu va Huyet hpc Nhi nay , cac nha nghien ciiu bao cao ket qua dieu tri cua 16 tre em trong nam 2011, bi viem niem mac mieng do hoa tri. Cac tie gia luu y rang, mac dii c6 phu thupc vao muc dp viem niem mac cua niem mac mieng, nhung trung binh, chi cin chieu 2,5 lin da mang lai hieu qua va neu thuc hien chieu trong vong 1 tuan thi chira lanh hoan toan cac ton thuong niem mac.
Cac tic gia tin rang laze cuong dp thap la mpt trong nhimg phuang phap hien dai va tien tien nhit de dieu tri cac bien chirng cua hoa tri. [6]
Phuang phap nay dac biet de dang ap dung, ma khong yeu ciu dao tao rpng rai ciia nhan vien y te, dp an toan va hieu qui dieu tri caola nhirng yeu to cho phep ap dung rpng rai dieu tri laze trong thuc hanh lam sang ung thu.
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UbiraHKHH B.H. " flp. JTasepuafl TepanHH ocjioacHeuHH XHMHO- H
jiyHCBoro jieHCHHfl jiHM(J)onpojiH{|)epaTHBHtrx
3a6ojieBaHHH y ;teTeH // AercKaa OHKOJiorHa.-1997.-X23-4.-C.47.
2. BajiaKHpeB C.A., flypHOB JI.A., FyceB JI.H., H jxp- HuaKOHHTeHCHBHbie Jiaaepbi e ;ieTCKOH oHKOJioruH //
BecTHHK PoccHHCKOH AKa^eMMH Me;t.
HayK, 2000.-N 6.-C.24-27
3. /^ypHOB JI.A., BanaKHpes C.A., FyccB JI.H. H flp.//npHMeHeHHe HH3KOHHTeHCHBHOH JiasepUOH TepanHH B ACTCKOH OHKOJioruH (3KCnepHM. H KJIHH. HCCJlC/lOBaHHa) / / C6.HayH.Tp.VI Meatoyn. uayMHO- npaKTHH. KOHlJ). n o KBaUTOBOH MeAHUHHe.-M.-1999.- C.186-188.
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6. Cauwels RG, Martens LC. Low level laser therapy in oral mucositis: a pilot study // Eur Arch Paediatr Dent 2 0 1 ! Apr 12(2) 118-23
7. Hae Ja Kim, M D , Shi Youn Rho, M D , and Yong Sup Shin, MD.
Effects of Low Level Laser Therapy on Oral Mucositis Caused by Anticancer Chemotherapy in Pediatric Patients // The Joumal of The Korean Pain Society 2001 Jun; 14(01) 51-55
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Quaghebeur, J., D e Porre, et al. Lov level lazer therapy in the treatment of oral mucositis on an adult hematology and a pediatric hemato-oncology ward // 37th E B M T Annual Congress, August 2011 - Vol.31-Issue 2
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