解毒生肌方防治食管癌放疗所致急性放射性食管炎的临床观察

Curative Effect of Jiedu Shengji Recipe in Preventing and Treating Acute Radiation Esophagitis in Radiotherapy Induced Esophageal Carcinoma Patients

目的 观察中药解毒生肌方对食管癌放疗所致急性放射性食管炎的防治效果。方法 86例中晚期食管癌患者按随机数字表法分为治疗组（43例）和对照组（43例）,两组均采用同步放化疗。治疗组自放疗开始给予中药解毒生肌方（每日1剂,共8周）,对照组给予由地塞米松、利多卡因及庆大霉素配制的混合液口服（每次放疗前、后30 min内口服10 m L,放疗结束后停止服药）。观察两组患者急性放射性食管炎的发生时间及症状持续时间、食管的放射性损伤程度、治疗效果、治疗后卡氏评分（Karnofsky performance scale,KPS）改善率及不良反应发生率。结果 与对照组比较,治疗组急性放射性食管炎发生时间延长[（15.46±3.37）天vs（10.23±2.46）天],症状持续时间缩短[（20.18±4.56）天vs（26.17±3.26）天],差异均有统计学意义（P〈0.01）;治疗组Ⅱ级以上急性放射性食管炎的发生率低于对照组（Z=3.34,P〈0.01）;治疗组总有效率为95.35%（41/43）,对照组总有效率为67.44%（29/43）,治疗组优于对照组（χ~2=11.06,P〈0.01）;治疗组和对照组KPS评分改善率分别为65.12%（28/43）、27.91%（12/43）,两组比较,差异有统计学意义（χ~2=11.97,P〈0.01）;治疗组不良反应发生率为9.30%（4/43）低于对照组的34.88%（15/43）,差异有统计学意义（χ~2=8.17,P〈0.01）。结论 中药解毒生肌方对食管癌同步放化疗中出现的中重度急性放射性食管炎有较好的防治作用。

Objective To observe the curative effect of Jiedu Shengji Recipe（JSR） in preventing and treating acute radiation esophagitis in radiotherapy induced esophageal carcinoma patients. Methods Totally 86 mid-late stage esophageal carcinoma patients were assigned to the treatment group and the control group according to random digit table, 43 in each group. All patients received concurrent radiochemotherapy. Patients in the treatment group took JSR from starting the radiotherapy, one dose per day for 8 successive weeks, while those in the control group took mixture of dexamethasone, lidocaine, and gentamicin, 10 m L each time, taken before radiation and within 30 min after radiation, discontinued till the end of radiation. The occurrence time of acute radiation esophagitis and duration of symptoms, esophageal radioactive damage degree, curative effect, improvement rate of Karnofsky performance scale（KPS）, and the incidence of adverse reactions were observed in the two groups. Results Compared with the control group, the occurrence time of acute radiation esophagitis was prolonged（15. 46 ± 3. 37 days vs 10. 23 ± 2. 46 days）,and duration of symptoms was shortened（20. 18 ± 4. 56 days vs 26. 17 ± 3. 26 days） in the treatment group, with statistical difference（P 0. 01）. In the treatment group the occurrence rate of mid and high level（degree Ⅱ to degree Ⅳ）acute radiation esophagitis was lower than that of the control group（Z = 3. 34, P 0. 01）. The total effective rate was95. 35%（41/43） in the treatment group and 67. 44%（29/43） in the control group, with statistical difference between the two groups（χ2= 11. 06, P 0. 01）. The improvement rate of KPS were higher in the treatment group than in the control group [65. 12%（28/43） vs 27. 91%（12/43）; χ2= 11. 97, P 0. 01]. The incidence of adverse reactions were lower in the treatment group than in the control group with statistical difference [9. 30%（4/43） vs 34. 88%（15/43）; χ2= 8. 17, P 0. 01]. Conclusion JSR had better effect for preventing and treating moderate and severe acute radiation esophagitis in concurrent chemoradiotherapy induced esophageal carcinoma patients.