清热利湿解毒方辅助西药灌肠治疗宫颈癌放疗致放射性肠炎疗效观察

Curative Effect of Qingre Lishi Jiedu Decoction and Western Medicine Enema on Radiation Enteritis Caused by Radiotherapy for Cervical Cancer

目的探讨清热利湿解毒方辅助西药灌肠治疗宫颈癌放疗致放射性肠炎的疗效及对患者血清转化生长因子-β1(TGF-β1)和生活质量的影响。方法选取2015年1月-2018年1月我院收治的宫颈癌放疗致放射性肠炎患者200例,按随机数字表法将患者分为观察组(n=100)和对照组(n=100)。对照组给予西药灌肠治疗,观察组在对照组的治疗基础上加服清热利湿解毒方治疗。观察两组患者综合疗效、内镜疗效以及治疗前后主要证候评分、生活质量评分和血清TGF-β1水平,记录治疗过程中不良反应发生情况。结果治疗后,两组腹部刺痛、泻后不爽、面色晦滞、肛门灼热、小便短黄评分及血清TGF-β1水平较治疗前均降低,且观察组上述指标均明显低于对照组(P<0.05);两组躯体功能、认知水平、角色功能、社会职能及情感职能评分较治疗前均提高,且观察组上述指标评分均明显高于对照组(P<0.05);观察组综合疗效和内镜疗效总有效率分别为86.0%、90.0%,均明显高于对照组的60.0%、68.0%(P<0.05);两组不良反应发生率比较差异无统计学意义(P>0.05)。结论清热利湿解毒方辅助西药灌肠治疗宫颈癌放疗致放射性肠炎的疗效确切,可有效缓解患者临床症状体征,降低TGF-β1水平,促进肠道粘膜修复,提高生活质量。

Objective To investigate the curative effect of Qingre Lishi Jiedu decoction( QLJD) assisted enema with western medicine on radiation enteritis caused by radiotherapy for cervical cancer and its influence on serum transforming growth factor-β1( TGF-β1) and quality of life.Methods One hundred cases of radiation enteritis caused by radiotherapy for cervical cancer were randomly divided into the observation group and control group,with 50 cases in each. The control group was given enema with western medicine,while the observation group was additionally given Qingre Lishi Jiedu decoction. The comprehensive efficacy,endoscopic efficacy,scores of main syndromes,scores of quality of life and serum TGF-β1 levels of the two groups of patients were observed before and after treatment. The incidence of adverse reactions during treatment was recorded. Results After treatment,the abdominal pain,diarrhea discomfort,blurred complexions,anus burning,urinary yellowing score and serum TGF-β1 levels in the two groups were reduced,especially in the observation group( P<0.05). The scores of physical function,cognitive ability,role function,social function and emotional function of the two groups were higher after treatment,especially in the observation group( P<0.05). The total effective rates of the observation group were 86.0% and 90.0% respectively,which were significantly higher than those of the control group( 60.0% and 68.0%,P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups( P> 0.05).Conclusion Qingre Lishi Jiedu decoction assisted enema with western medicine has a definite effect on radiation enteritis caused by radiotherapy for cervical cancer. It can effectively alleviate the clinical symptoms and signs of patients,reduce the level of TGF-beta 1,promote the repair of intestinal mucosa and improve the quality of life.