中西医结合治疗对肺癌化疗后腹泻患者肠黏膜通透性的影响及疗效观察

Effect and efficacy of integrated Chinese and western medicine on intestinal mucosa permeability in the patients with diarrhea after chemotherapy for lung cancer

目的探讨中西医结合治疗对肺癌化疗后腹泻患者肠黏膜通透性的影响及疗效。方法选取2016年1月~2017年6月门诊或住院治疗的肺癌化疗后腹泻患者78例,随机分为中西医组和西医组。西医组患者均给予蒙脱石散口服、补液(静脉或口服)纠正水电解质酸碱平衡紊乱等西医常规治疗,中西医组在西医组治疗基础上加用加味芍药汤,两组均连用72 h。判断并比较两组治疗前后血清ET、D-乳酸和TNF-α变化情况,并比较临床效果。结果治疗72 h后,两组血清ET、D-乳酸和TNF-α指标明显下降(P<0.05或P<0.01),且在下降程度上中西医组较西医组更显著(P<0.05);同时中西医组总有效率较西医组更高(χ~2=4.52,P<0.05)。结论中西医结合治疗肺癌化疗后腹泻患者的效果较肯定,能显著降低血清ET、D-乳酸和TNF-α水平,保护肠黏膜屏障降低其通透性。

Objective To investigate the effect efficacy of integrated traditional Chinese and western medicine on intestinal mucosal permeability in the patients with diarrhea after chemotherapy for lung cancer. Methods From January2016 to June 2017, 78 patients with diarrhea after chemotherapy for lung cancer who were treated in the outpatient clinic or during hospitalization were selected, and were randomly divided into integrated Chinese and western medicine group and western medicine group. The patients in the western medicine group were given montmorillonite powder, rehydration（intravenous or oral） to correct water and electrolyte acid-base balance disorders and other western conventional treatments. The integrated Chinese and western medicine group was further given modified Shaoyao Decoction on the basis of the western group. Both groups were given the dosage for 72 h. The changes of serum ET, D-lactate and TNF-α before and after treatment were determined and compared between the two groups, and the clinical effect was compared. Results After 72 hours of treatment, the levels of serum ET, D-lactate and TNF-α indices in the two groups were significantly decreased（P〈0.05 or P〈0.01）. And in the degree of decrease, the integrated Chinese and western medicine group was more significant than the western medicine group（P〈0.05）; at the same time, the total effective rate in the integrated Chinese and western medicine group was higher than that in the western medicine group（χ~2=4.52, P〈0.05）. Conclusion Integrated Chinese and western medicine in the treatment of diarrhea after chemotherapy for lung cancer has more positive effects, which can significantly reduce the serum ET, D-lactic acid and TNF-α, and protect the intestinal mucosal barrier to reduce its permeability.