国产醋酸奥曲肽与洛哌丁胺对比治疗盆腔放疗相关性腹泻

The comparing research of domestic octreotide and loperamide in the treatment of acute diarrhea related pelvic radiotherapy

目的:了解国产醋酸奥曲肽(依普比善)及洛哌丁胺治疗Ⅱ、Ⅲ级以上盆腔放疗相关性急性腹泻的疗效及不良反应情况。方法:盆腔放疗过程中发生Ⅱ-Ⅲ级腹泻的59例患者列入本观察项目,26例患者接受洛派丁胺治疗(首次剂量4mg,每4h给予2mg口服),33例患者接受依普比善治疗(100μg,皮下注射,tid),连续治疗5d后判断疗效。结果:洛哌丁胺组腹泻完全缓解率为34.6%,依普比善组为66.7%,差异有显著性。是否需要输液治疗及停止放疗时间2组差异具有显著性,P<0.05。洛哌丁胺治疗无效改用依普比善的腹泻缓解率为70.6%,依普比善治疗失败后提高依普比善治疗剂量仍有45.4%的腹泻缓解率。结论:国产奥曲肽依普比善治疗放疗相关性急性腹泻有效率显著高于洛哌丁胺,可显著降低腹泻患者需要输液治疗的比率,并缩短因腹泻导致放疗中断的时间。对于腹泻程度较重患者,尽早使用依普比善或提高依普比善剂量是较为合理的选择。

OBJECTIVE To explore and compare the potential efficacy of domestic octreotide and loperamide in the treatment of acute diarrhea related with pelvic radiotherapy. METHODS Fifty nine patients with grade Ⅱ or Ⅲ diarrhea during pelvic radiotherapy were enrolled into this research. Twenty six patients received the treatment of loperamide （initial dose 4 rag, po, and 2 mg q4h）, and thirty-three patients were given the subcutaneous injection of domestic octreotide （100 g, rid）. Their respective efficacy was justified after the continuous treatment for 5 days. RESULTS The complete remission rate of diarrhea in loperam ide group was 34. 6%,while that in domestic octreotide group was 66. 7%,and P〈0. 05. The proportion rate of patients＇ number with need for transfusion treatment and the duration of radiotherapy discontinuance in the two groups, were significantly different. The compiete remission rate of diarrhea of octreotide injection if loperamide was ineffective was 70. 6%, and that in octreotide ineffective cases of it was 45.4% if dose of octreotide was elevated. CONCLUSION The effective rate of domestic octerotide was significantly higher than that of loperamide in treating for acute diarrhea related with pelvic radiotherapy. Octreodie treatment could decrease the proportion rate of diarrhea patients who needed transfusion treatments and shorten the duration of radiotherapy discontinuance. For those patients with severe diarrhea, sooner using of octreotide or using octreotide in higher dose than common dose might be a more reasonable clinical choice.