Evaluation of the clinical efficacy and safety of Zhuhuang Powder combined with Qingyan Mixture in the prevention and treatment of radiation-induced oral mucositis: A retrospective cohort study

Radiation-induced oral mucositis (RIOM) is one of the most common acute toxic side effects in patients with nasopharyngeal carcinoma (NPC) undergoing radiotherapy, seriously affecting their quality of life and treatment compliance. Currently, there is a lack of effective and systematic integrative interventions combining traditional Chinese and Western medicine. This study aimed to evaluate the clinical efficacy and safety of Zhuhuang Powder combined with Qingyan Mixture in the prevention and treatment of RIOM. A retrospective cohort study was conducted, including 142 NPC patients who received radiotherapy at our hospital between January 2023 and January 2025. Patients were divided into a treatment group (n = 72) and a control group (n = 70). During radiotherapy, the treatment group received Zhuhuang Powder combined with Qingyan Mixture, while the control group received routine oral care. The 2 groups were compared in terms of RIOM incidence, time to first onset, pain scores (visual analogue scale), and adverse events. The overall incidence of RIOM was significantly lower in the treatment group compared to the control group (84.7% vs 92.9%, P = .004). The incidence of Grasde ≥ II mucositis also significantly decreased (29.2% vs 55.7%, P = .001). The time to first onset of mucositis was significantly delayed in the treatment group (23.27 ± 3.9 days vs 8.77 ± 1.38 days, P < .001), and the visual analogue scale score at week 4 was significantly lower (3.1 ± 1.2 vs 4.7 ± 1.4, P < .001). There was no significant difference in the incidence of adverse events between the 2 groups (P = .732), and no serious adverse events were observed in the treatment group. Zhuhuang Powder combined with Qingyan Mixture can effectively reduce the incidence of RIOM in NPC patients, alleviate symptoms, delay onset, improve nutritional intake, and demonstrates good safety, making it suitable for clinical application and promotion.