还原型谷胱甘肽联合消炎止痛药物合剂在急性放射性食管炎中的应用研究

Application research of reduced glutathione combined with anti-inflammatory analgesic mixture in the treatment of acute radiation esophagitis

目的 观察还原型谷胱甘肽联合消炎止痛药物合剂防治食管癌放射治疗期间急性放射性食管炎的效果。方法将2014年5月~2015年11月在河南科技大学第一附属医院住院行胸部放射治疗的72例食管癌患者随机分为实验组36例（还原型谷胱甘肽＋消炎止痛药物合剂）和对照组36例（消炎止痛药物合剂）,观察两组发生Ⅱ级及以上急性放射性食管炎的发生情况、食管黏膜耐受剂量及两组应用抗生素的比例。结果 72例患者完成了治疗。两组急性放射性食管炎的发生率为100.0%,其中实验组≥Ⅱ级急性放射性食管炎的发生率为33.3%,低于对照组的63.9%,差异有统计学意义（χ2=6.727,P〈0.01）,两组中均无Ⅳ级急性放射性食管黏膜损伤发生。同时实验组发生急性黏膜反应的耐受剂量均高于对照组（P〈0.01）。实验组放射性食管炎治疗中应用抗生素比例为13.9%,对照组为44.4%,差异有统计学意义（χ2=8.314,P=0.004）。结论 还原型谷胱甘肽在食管癌患者急性放射性食管黏膜损伤中有较好的预防和治疗效果,可以降低急性食管炎的发生率,减轻食管炎发生的严重程度。

Objective To observe effect of reduced glutathione combined with anti-inflammatory analgesic mixture in the prevention and treatment of acute radiation esophagitis during the radiotherapy for esophageal carcinoma.Methods 72 cases of esophageal carcinoma patients with thoracic radiotherapy in the First Affiliated Hospital of Henan Universi- ty of Science and Technology from May 2014 to November 2015 were randomly divided into experimental group and control group.Patients in the experimental group group received reduced glutathione combined with anti-inflammatory analgesic mixture during radiotherapy,while patients in the control group received anti-inflammatory alone.The inci- dence of actue radiation esophagitis,tolerance dose of esophageal mucosal and the proportion of patients for whom an- tibiotics were used in two groups were experimentald and evaluated.Results 72 patients all completed the treatment course.The incidence of grade I[ or above actue radiation esophagitis was 100.0% in two groups,The incidence of grade 11 or above actue radiation esophagitis in the experimental group and the control group was 33.3% and 63.9% respec- tively,and the difference was statistically significant （X2=6.727,P〈O.O1）,there were no gradelV acute esophageal mucosal injury in the two group.The tolerance dose of esophageal mucosa in the experimental group was higher than that in the control group （P〈0.01）.Use proportionof antibiotics in the treatment of radiation esophagitis in the experimental group was 13.9%,with 44.4% in the control group,and the difference was statistically significant （X2=8.314,P=0.004）.Conelu. sion Reduced glutathione has a good effect on the prevention and treatment of acute esophageal mucosal injury in pa- tients with esophageal carcinoma.It can reduce the incidence and severity of acute radiation esophagitis.