平溃散保留灌肠治疗急性放射性直肠炎30例临床观察

Clinical observation on 30 cases of acute radiation proctitis treated with Pingkuisan powder

目的观察平溃散保留灌肠治疗急性放射性直肠炎的临床疗效。方法将60例急性放射性直肠炎患者随机分为2组,治疗组30例予平溃散保留灌肠治疗,对照组30例予硫酸庆大霉素注射液、盐酸利多卡因注射液、地塞米松磷酸钠注射液、0.9%氯化钠注射液混合保留灌肠治疗。2组均治疗14 d后观察疗效,治疗前后症状积分变化和直肠镜检黏膜损伤分级变化。结果治疗组总有效率90.0%,对照组总有效率73.3%,2组总有效率比较差异有统计学意义(P<0.05),治疗组疗效优于对照组。治疗组治疗后各症状积分及总积分均较本组治疗前显著降低(P<0.05,P<0.01);对照组治疗后除排便困难、里急后重症状积分外,其他各症状积分及总积分均较本组治疗前显著降低(P<0.05,P<0.01)。治疗组治疗后少腹胀痛、排便困难、大便稀溏、脓血便、里急后重症状积分均低于对照组治疗后(P<0.05,P<0.01)。2组治疗后直肠镜检黏膜损伤分级均较本组治疗前改善(P<0.05),且治疗组改善更明显(P<0.05)。结论平溃散保留灌肠治疗急性放射性直肠炎,能明显改善患者的临床症状,且不良反应较轻,疗效明显优于单纯西药保留灌肠治疗。

Objective To observe the therapeutic effect of Pingkuisan powder on acute radiation proctitis. Methods 60 cases of acute radiation proctitis were randomly divided into treatment and control groups, the treatment group of 30 patients received retention enema of Pingkuisan. The control group of 30 patients was treated with gentamicin, lidocaine injection, dexamethasone, saline mixed retention enema. Efficacy, change of symptoms score before and after treatment and the rectal examination mucosal injury scale in both groups were observed after 14 days of treatment. Results The total efficiency was 90.0% in treatment group, 73.3% in control group. There was significant difference between two groups （P 〈 0.05 ）. Symptoms score and total score after treatment was decreased as compared with that before treatment in treatment group （ P 〈 0. 05, P 〈 0.01 ）. Symptoms score and total score （ in addition to the difficulty in defecation, tenesmus symptom score） after treatment was decreased as compared with that before treatment in control group （P 〈 0.05, P 〈 0.01 ）. Lower abdomen pain, bowel problems, loose stool, blood and pus, tenesmus symptom score in treatment group was lower than that in control group after treatment （P 〈 0.05, P 〈 0.01 ）. The improvement of the rectal examination mucosal injury scale in treatment group was superior to than in control group after treatment （ P 〈0. 05 ）. Conclusion Clinical efficacy of Pingkuisan Powder on acute radiation proetitis was significantly better than the control group. The treatment of Pingkuisan Powder on acute radiation proctitis, can significantly improve the patient＇s clinical symptoms, and less adverse reactions, significantly better than western medicine alone.