洛哌丁胺联合香砂六君子汤灌肠治疗伊立替康化疗后腹泻合并肠源性细菌感染的疗效及对血清炎性标记物的影响

Effect of Loperamide combined with Xiangsha Liujunzi Decoction enema therapy in diarrhea complicated with intestinal bacterial infection after Irinotecan chemotherapy and its influence on serum inflammatory markers

目的观察洛哌丁胺联合香砂六君子汤灌肠治疗伊立替康化疗后腹泻合并肠源性细菌感染的疗效及对血清炎性标记物的影响。方法将130例伊立替康化疗后腹泻合并肠源性细菌感染患者随机分为观察组和对照组各65例,对照组给予盐酸洛哌丁胺胶囊治疗,观察组在对照组基础上给予香砂六君子汤灌肠治疗,疗程均为2周;观察2组治疗前后腹泻分级情况、粪便病原菌培养阳性及菌株检出情况和Karnofsky功能状态评分情况,检测2组治疗前后血清炎性标记物降钙素原(PCT)、C反应蛋白(CRP)、白细胞介素-6(IL-6)水平。结果 2组治疗后的腹泻分级均显著改善,观察组改善情况优于对照组,且止泻率(腹泻分级为0级)高于对照组(P<0.05);治疗后观察组粪便病原菌培养阳性率及病原菌检出株数均明显低于对照组(P均<0.05);2组治疗后Karnofsky功能状态评分均显著升高(P均<0.05),且观察组显著高于对照组(P<0.05);2组治疗后血清PCT、CRP、IL-6水平均显著降低(P均<0.05),且观察组上述指标水平均低于对照组(P均<0.05)。结论洛哌丁胺联合香砂六君子汤灌肠能够缓解伊立替康化疗后腹泻合并肠原性细菌感染患者腹泻症状,提高止泻率,抑制病原菌感染,提高机能状态和生活质量,并抑制血清炎性标记物水平,值得临床推荐。

Objective It is to observe the effect of Loperamide combined with Xiangsha Liujunzi Decoction(XSLJZD)enema therapy in diarrhea complicated with intestinal bacterial infection after Irinotecan chemotherapy and its influence on serum inflammatory markers.Methods130patients with diarrhea complicated with intestinal bacterial infection after Irinotecan chemotherapy were randomly divided into observation group(65cases)and control group(65cases),the patients were treated with Loperamide Hydrochloride Capsules in the control group,and with Loperamide Hydrochloride Capsules combined with XSLJZD enema therapy in the observation group,the course of treatment was2weeks.The grading of diarrhea,the positive rate of pathogenic bacteria culture,the detection of bacteria and the score of Karnofsky functional status were observed before and after treatment in the two groups,and the levels of serum inflammatory markers procalcitonin(PCT),C reactive protein(CRP)and interleukin6(IL6)were detected before and after treatment in the2groups.Results After treatment,the Diarrhea grading was significantly improved in the two groups,and the improvement of the observation group was better than that of the control group,the antidiarrhea rate(diarrhea grade0)of the observation group was higher than that of the control group(P<0.05);After treatment,the fecal pathogenic bacteria culture positive rate and pathogen detection number of the observation group were significantly lower than the control group(all P<0.05);the scores of Karnofsky functional status after treatment were significantly higher in both groups(all P<0.05),and which of the observation group was significantly higher than the control group(P<0.05);after treatment,the serum PCT,CRP and IL6levels in the two groups were significantly decreased(all P<0.05),and the above indexes in the observation group were significantly lower than those in the control group(all P<0.05).Conclusion Loperamide combined with XSLJZD enema therapy can alleviate the symptoms of diarrhea in patients with diarrhea complicated with intestinal bacterial infection after Irinotecan chemotherapy,increase antidiarrhea rate,inhibit pathogenic bacteria infection,improve functional status and quality of life,and inhibit the level of serum inflammatory markers,it is worthy of clinical recommendation.