中药口服加灌肠治疗放射性肠炎43例疗效观察

Curative Observation of Applying Traditional Chinese Medicine Taken Orally Plus Traditional Chinese Medicine Enema in the Treatment of Radiation Enteritis

目的:观察中药口服加灌肠治疗放射性肠炎的临床疗效。方法:将84例盆腹腔放疗的肿瘤患者随机分为中药组43例和西药组41例,中药组每日放疗结束后采用中药保留灌肠2小时,每日1次,同时给予中药清热化湿、益气健脾剂口服;西药组每日放疗结束后采用生理盐水加蒙脱石散、地塞米松保留灌肠2小时,每日1次,自出现腹泻时口服蒙脱石散、左氧氟沙星。放疗结束后比较两组患者的肠道急性放射性损伤程度及生存质量。结果:中药组在中医证候疗效、急性放射性肠炎Ⅱ级以上的发生率明显少于西药组,有统计学差异(P<0.05);放疗后中药组卡氏评分(KPS)80分以上者明显高于西药组,有统计学差异(P<0.05)。结论:中药口服加灌肠能够有效防治放射性肠炎的发生,减轻放射损伤,降低肠道毒性反应。

Objective： To observe the therapeutic effect of applying traditional Chinese medicine taken orally plus traditional Chinese medicine enema in the treatment of radiation enteritis. Methods： 84 cases of abdominal radiotherapy for cancer patients were randomized into the Chinese medication（ radiotherap ﹢ oral Chinese medication ﹢ Chinese medication enema） group of43 cases and western medication（ radiotherapy ﹢ oral western medicine ﹢ western medicine enema） group of 41 cases. For the Chinese medication group,traditional Chinese medicine decoction was used for enema after radiotherapy each day,the clearing away heat and eliminating dampness,replenishing Qi to invigorate the spleen formula was taken orally at the same time; for western medication group,normal saline added with smecta and dexamethasone was given to the western medication group for enema,once everyday after radiotherapy,and smecta and levofloxacin were given orally when diarrhea appeared. The intestinal acute radiation injury degree and quality of life in both groups were observed after treatment. Results： The traditional Chinese medicine symptom score,the incidence of acute radiation enteritis above grade II in the Chinese medication group was significantly less than that in the western medication group（ P〈0. 05）. Patients with KPS score aboye 80 points was significantly more in the Chinese medication group than in the western medication group（ P0. 05）. Conclusion： Chinese medication oral medication and enema for radiation enteritis can obviously reduce the incidence of acute radiation enteritis and effectively improve the quality of life of patients.